MEDICARE

10 Things Medicare Won’t Tell You


An interesting WSJ article by Catey Hill and Elizabeth O'Brien including a few things you may not know about Medicare, such as some costly glitches in the entitlement program. I'm guessing that you will find at least a couple of things you didn't know about Medicare in this article. Click below to read more.

http://www.marketwatch.com/story/10-things-medicare-wont-tell-you-2013-03-08


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

10 Top Tips For Choosing The Medicare Supplement Plan That You Feel Suits You Best


Rules can vary by state, so the below tips are for Florida.

  1. Understand that a Medicare Supplement insurance plan, is just that. It only “supplements" original Medicare (Part A & Part B). Also keep in mind that original Medicare doesn’t cover everything.

  2. Most prescription drugs are not included with a Medicare Supplement. (Only a very limited drugs are covered under Part A or Part B.) So if you also want prescription drug coverage, you will need to purchase a stand-alone prescription drug plan (also known as Part D) in addition to a Medicare Supplement Plan. 

  3. Medicare’s Annual Enrollment Period is from October 15 through December 7. Although you can add a Medicare Supplement anytime during the year, if you are currently on original Medicare and can qualify. However if you have a Medicare Advantage Plan and want to switch to a Medicare Supplement, then you will need to do that during Annual Enrollment Period October 15 through December 7 or possibly during Medicare Open Enrollment Period January 1 to March 31 when some different rules may apply.)

  4. Medicare Supplement Insurance plans (also know as Medigap plans) can help pay for some of your out of pocket costs not covered by original Medicare (Part A & Part B).

  5. Choosing the right Medicare insurance plan for yourself depends on what you feel suits you the best and at the same time you can afford along with being with a financially stable insurance company.

  6. Applicants qualify for Medicare Supplement Open Enrollment during the first six months they are enrolled in Medicare Part B. During Medicare Supplement open enrollment, you cannot be denied coverage, regardless of your medical history. So it is important you don’t miss that deadline. Unless you qualify for guaranteed issue later on, if you don’t enroll during this Medicare Supplement open enrollment period you will need to go through underwriting for approval and some people may not qualify due to the insurance company’s underwriting guidelines.

  7. Medicare Supplement Insurance plans only cover one person per policy. So if your spouse wants coverage, he/she will also need to purchase a separate policy.

  8. Medicare Supplement Insurance plans (A through N) are standardized, which means each plan with the same letter will offer the same coverage. (Exceptions are Minnesota, Wisconsin and Massachusetts.)

  9. Since Medicare Supplement Insurance plans with the same letter offer the same coverage, it is important to know that premiums can vary widely from one insurance company to another, even though they offer the same exact coverage. So you basically want to find the lowest premium through a reliable insurance company.

  10. Another thing to keep in mind is try to find out the annual increase history of the insurance company you pick for your Medicare Supplement plan insurance. You don’t want to purchase a plan that has historically had large annual increases, since if that happens in the future years you may not qualify (due underwriting guidelines) to switch to another insurance company’s Medicare Supplement later on down the road.












Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

A Bit of Clarity in the Murk of Medicare Politics

In this Herald-Tribune article by Barbara Peters Smith, she mentions that when people say Medicare is going bankrupt, the fact is Medicare can't go bankrupt in the classic sense. To find out more details, click below to read her short article.

http://health.heraldtribune.com/2013/05/10/a-bit-of-clarity-in-the-murk-of-medicare-politics/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

A Medicare Tax Break


This Wall Street Journal article by Bill Bischoff is about how some self-employed people can deduct Medicare Insurance Premiums. If you are not already familiar with this topic, it is important information and good news for self-employed seniors. But as always, it is best to check with your accountant for your individual situation. Click on link below to read more. 

http://www.marketwatch.com/story/a-medicare-tax-break-2013-05-06


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Behind Medicare’s Hospital Bill ‘Discount’


A short Wall Street Journal article by Matthew Heimer mentioned the so called discount that Medicare obtains on hospital bills. It stated that the price comparison website NerdWallet released a study and found a catchy way to summarize: "Medicare obtains a discount of 73% on the average hospital bill," the site says, paying 27 cents for every dollar it's charged. It goes on to say that the hospital list prices are almost always higher than what Medicare or any private insurer will pay. Also another way to flip the same data might be to say that the average hospital charges Medicare 3.7 times as much as Medicare is likely to pay it. Along with many others, I personally feel this has the effect of over inflating overall health care costs and many without health insurance get hit the hardest!

Although the original web link is no longer working, I listed the original source below anyway.

Source: http://blogs.marketwatch.com/encore/2013/06/04/behind-medicares-hospital-bill-discount/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Beware of Shifting Options Within Medicare Plans


In this New York Times article by Tara Siegel Bernard, it mentions that there are so many Medicare Insurance plan choices that it can be mind boggling! To add to the confusion, even if you stay with an existing Medicare Insurance plan you already have, there can be changes within that same plan from year to year. That is why once you pick an initial plan, it is still important to review your existing plan each year for any changes to see if the plan still best fits your needs! If the upcoming year plan changes affect you a lot, you may possbily be better off switching to a new plan for the new year. However many seniors either don’t want the hassle of reviewing new plans to compare with their existing plan or are just plain scared of making any changes. Keep in mind, it is important not to just stay in an existing plan because you are overwhelmed with all the choices.

To read the full article, click on the web link below.

http://www.nytimes.com/2014/10/04/your-money/beware-of-shifting-options-within-medicare-plans.html?_r=2


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Bradenton Among Most Expensive Places To Be A Medicare Patient


Click on link below to read an article bA new federal tool to evaluate hospital-related spending ranks Florida — and especially Bradenton — among the most expensive places to be a Medicare patient.

http://health.heraldtribune.com/2012/05/15/bradenton-among-most-expensive-places-to-be-medicare-patient/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Do I Need Part A & Part B at Age 65?


It all depends on your individual circumstances. Be sure to determine correct information on when to enroll regarding your individual circumstances or you may end up paying some hefty penalties for the rest of your life for enrolling late!

Some general tips:

If you want to get either a Medicare Supplement and Prescription Drug Plan OR instead a Medicare Advantage plan, you will first need to be enrolled in both Part A and Part B.

Although if you are still working at age 65, have credible health insurance through your employer, and want to keep to your employer health insurance, generally you do not need to enroll in Part A or Part B immediately. (Rules can differ depending on the number of employees at your company. Less than 20 employees has different rules.) 
It is always best to check with your benefits administrator to determine if you should enroll in Part A or Part B to be sure. 

However Part A is usually free for most people (if you worked 40 quarters, paid Medicare taxes during that time, and also are a US citizen or permanent legal resident for at least 5 years).
So you may want to enroll in Part A, even while you are still working since it free for most people.
 Then later enroll in Part B right away when you first retire or leave your work to avoid any hefty penalties. Note: There is a monthly premium for Part B.

Note: If you choose COBRA after you stop working, do not wait until your COBRA coverage ends to sign up for Medicare! (Check with the Social Security office for details on when you need to enroll to avoid penalties, etc.) If you delay enrolling in Medicare Part A or Part B after your Special Enrollment Period ends, you’ll have to wait until the next General Enrollment Period (January 1 to March 31 every year) to enroll, and you may have to pay hefty late enrollment penalties added to your premiums for the rest of your life if you choose to keep Medicare.


For a relate blog post, click the web link below:

How Do I Get Medicare Part A & Part B?


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Drug Prices - Gag Rule At Pharmacy About Lower Prices?


I came across very interesting two minute 15 sec video and also on the same web page an article on a different subject regarding the gag rule for prescription drugs. I felt both the article and video were very informative and worth reading and/or viewing.

Disclaimer: There may be be a random commercial, (possibly even political?) preceding the video. I have no affiliation with any of these commercials and I just ignore them altogether myself and recommend you do the same.

When gag clauses are in effect, pharmacists are barred from telling consumers about less expensive price options because of the clauses in their contracts with PBMs. The clauses specifically prevent pharmacists from discussing less costly alternatives, including therapeutically similar drugs.

Some specific states already have their own state laws banning the gag rules. Many states have bills introduced into legislation in 2018 or passed already. 

"In the past two years, at least 21 states have enacted laws prohibiting "gag rules" on pharmacists, according to the Prescription Drug Resource Center of the National Conference of State Legislators. The most recent legislation was passed in Arizona, Colorado, Florida, Indiana, Kansas, Kentucky, Mississippi, Utah, Virginia and West Virginia between March and May.”1


Click the web link below to read view short video or read article.

https://www.cnn.com/2018/05/11/health/pharmacy-gag-rule-trump-lower-drug-prices/index.html


Click on web link below for related article in the local Sarasota Herald-Tribune

https://www.heraldtribune.com/zz/news/20180925/pharmacists-may-soon-be-allowed-to-tell-you-cheapest-way-to-get-prescriptions



1. Source: Article By Sandee LaMotte, CNN - Updated 7:53 PM ET, May 11, 2018
https://www.cnn.com/2018/05/11/health/pharmacy-gag-rule-trump-lower-drug-prices/index.html


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Fighting A Costly Medicare Loophole


Some out of pocket expenses that Medicare may not cover are described in this Encore article by Anne Tergesen. The article suggests you ask doctors whether you are considered inpatient or outpatient when going to the hospital. The status known as being under “observation care” can cause problems to arise because that is considered outpatient for billing purposes. However being outpatient can have other consequences, such as when being discharged from the hospital and if rehabilitative services are needed, Medicare won’t pick up the tab, which can be significant! Also different copayments, etc. can be affected for outpatient versus inpatient.


Source: Encore article by Anne Tergesen. 
Although the web link is no longer accessible, I listed the original source web link anyway: 
http://blogs.marketwatch.com/encore/2013/07/31/fighting-a-costly-medicare-loophole/



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Get What’s Yours For Medicare


I found this informative MarketWatch article about Medicare by Alessandra Malito and thought I’d share it. 

Gist is:

  • Medicare can be very confusing to seniors!
  • No one told me! (It is assumed that since Medicare is a government program that there should be people out there to tell you how to use it.) Hint: Find an experienced independent insurance agent that specializes in Medicare, such as myself!
  • Sign up for Medicare at the correct time or you may get steep penalties.
  • Understand that as long as you have continuous credible group coverage through your employer, generally you don’t need to sign up for Medicare right at age 65 to avoid penalties. However for employers with fewer than 20 employees, generally you have to get Medicare because small employer plans become secondary and Medicare becomes the primary player.
  • Understand and use the Medicare coverage you have. Also understand what is not covered, such as Long Term Care, for example.


For more information, click on web link below read entire article.

http://www.marketwatch.com/story/this-man-wants-you-to-get-whats-yours-from-government-benefits-2016-09-29


Confused and/or want more information about how to enroll in a new (or different) Medicare Insurance Plan or which Medicare Insurance plan to enroll in, please call me at 941-404-5334 to set up an appointment to discuss further. If relatively local, I’ll come right at your home, office, or other location.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


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Related Topic:

Click on web link below to find out answer.

Medicare Insurance Plans - Do Agents Charge Clients Fees?

Health Advantages Of Medicare Advantage


Some people feel strongly one way or the other about Medicare Advantage plans. A USA Today Columnist's opinion article by Daniel Gorlin and Jon Kaplan appeared to give a very favorable view. The article goes on to say that Medicare Advantage patients enjoy better health outcomes. If you are interested in reading the article mentioned above, click on the link at the bottom of this blog post. 

Keep in mind that with most Medicare Advantage plans will have what I call "pay as you go" type expenses such as co-pays, co-insurance, etc. for different benefits. However, below I listed some of the nice features / benefits of some Medicare Advantage plans.

Many Medicare Advantage plans may have these benefits:

  • Don't have a monthly premium.
  • Include Prescription Drug coverage in the same plan.
  • May include additional benefits such as: vision services, hearing services, health screening tests, nurse helplines, fitness programs, and some plans even include limited dental services, etc.
  • Cap your out of pocket spending for the year.
  • Have lower in-network pricing, but some plans allow you to go out-of-network if you pay more.
  • Some plans allow you to travel in other states and still be covered in-network.
  • They try to keep the emphasis on heather living and preventive care.
     

However, you probably heard the saying, "One size doesn't fit all!"  With that said, Medicare Advantage can be very good for some folks, but one particular type plan isn't always a good fit for everybody. 

So on the other hand, some folks that may be more able to afford monthly premiums and like a larger choice of doctors by not being confined to a network, or perhaps are sickly; may chose to go with Original Medicare and add a Medicare Supplement plan as well as a Prescription Drug Plan. Depending on which Insurance Company and Medicare Supplement Plan Letter type that are chosen, the coverage and premiums will vary. However, with most Medicare Supplement plans you are not limited to a network of doctors. If the doctor's office accepts original Medicare, generally they'll accept a Medicare Supplement plan to fill the gap or you may be able to get reimbursed. (For example with a Medicare Supplement Plan F in Florida, with a few exceptions just about everything is covered for your Medical expenses. You'll still need to have Part A and B in order to get a Medicare supplement though, but then after that, you just pay a flat monthly premium for Medical Supplement premium and you're done.) Although if you choose to also have prescription drug plan, you'll still have an additional premium for that plan as well, plus other out of pockets expenses such as prescription co-pays, possibly even a deductible depending on the prescription drug plan. If applicable, you may also have additional gap expenses if your prescription drug combined amounts go over the gap levels, etc.

http://www.usatoday.com/story/opinion/2013/07/02/health-advantages-of-medicare-advantage-column/2480001/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Health Insurance Marketplaces Are Not For Seniors


In this USA Today article by Susan Jaffe from Kaiser Health News it reminds Medicare beneficiaries that they are already covered and that their benefits are not changing for this upcoming 2014 year. They don't need to do anything with the new Marketplace because they don't apply to seniors.

So, if you are already 65 years old and on Medicare you don't need to be involved in the marketplaces. However during the Annual Election Period of Oct 15 through Dec 7, which is totally separate and different from the Marketplaces, seniors can shop for private health plans known as Medicare Advantage plans and if they don't like their current plan they can switch to a different Medicare Advantage plan or to a Medicare Supplement and/or Part D for their prescription drugs.

To read more click on the link below.

http://www.usatoday.com/story/money/business/2013/08/24/medicare-health-insurance-marketplace/2692977/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How are Medicare Advantage plans different from Original Medicare?


Medicare Advantage plans are an alternative option to Original Medicare. Medicare Advantage plan are also known as "Medicare Part C" plans. Medicare Advantage plans are offered by "private insurance companies" and cover all Medicare covered services.

All Medicare Advantage plans are required to offer at least the same benefits and coverage as original Medicare Parts A and B. Most Medicare Advantage plans (but not all) also include Medicare Part D. Depending on the specific Medicare Advantage plan you choose, it may also pay for additional services that aren’t covered by Original Medicare. Many people (but not all) feel the benefit of Medicare Advantage plans is that they offer more coverage than original Medicare. It boils down to personal preference. One type plan doesn’t fit everybody!

Keep in mind: With original Medicare there is not an annual maximum out of pocket expense cap on what you pay out of pocket. However on the other side, Medicare Advantage plans do have an out-of-pocket maximum limit each year! Once you hit a certain dollar amount, your plan pays 100% of the cost for most services it covers. Example: If you had Original Medicare and your covered Medicare medical bills came to $1,000,000.00, you could still be responsible for your 20% coinsurance share of $200,000.00! In that same scenario, if you had a Medicare Advantage plan and your covered Medicare medical bills came to $1,000,000.00, you would only be responsible for your maximum annual out of pocket amount. (Depending on your specific plan, but could be just $6,700.00.)

In most Medicare Advantage plans, (but not all) you can only go to doctors, specialists, and hospitals in the plan’s network. Otherwise, you may pay more if you go out of network. Additionally if you go out of network with some plans (Example: HMO plans) you may not even be covered at all for services, unless it is a true emergency. Although as I mentioned, if you need urgent or emergency care you will be covered, even if you receive care outside the plan’s participating providers. Some examples of Medicare Advantage plans include Health Maintenance Organizations (HMO) or Preferred Provider Organizations (PPO).


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


How Do I Get Medicare Part A & Part B?

Do I need Part A and Part B?

If you want to get either a Medicare Supplement and Prescription Drug Plan OR instead a Medicare Advantage plan, you will first need to be enrolled in both Part A and Part B.

How do I get Part A and Part B?

Some people get Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) automatically and other people have to sign up for it. In most cases, it depends on whether you’re getting Social Security benefits.1 

Below are some situations that may apply to you:

  • I’ll be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before I turn 65
    In most cases, you'll automatically get Part A and Part B starting the first day of the month you turn 65. Note: If your birthday is on the first day of the month, Part A and Part B will start the first day of the prior month!
    You don’t need to sign up if you automatically get Part A and Part B. You should receive your red, white, and blue Medicare card in the mail 3 months before your 65th birthday.


  • I won’t be getting benefits from Social Security or the Railroad Retirement Board (RRB) at least 4 months before I turn 65.
    If you aren’t getting benefits from Social Security (or the RRB) at least 4 months before you turn 65, you'll need to sign up with Social Security to get Part A and Part B.
    (Note: You should generally sign up three months in advance of your 65th Birth Month, since it can take a while to process your enrollment.)
    So how do I sign up?
    • Apply online at Social Security. If you started your online application and have your re-entry number, you can go back to Social Security to finish your application.
    •  Visit your local Social Security office.
    •  Call Social Security at 1-800-772-1213 (TTY: 1-800-325-0778).
    •  If you worked for a railroad, call the RRB at 1-877-772-5772.
    •  If you already have Part A and want to sign up for Part B, complete an Application for Enrollment in Part B (CMS-40B). 


  • I'm under 65 and have a disability.

       You automatically get Part A and Part B after you get one of these:

            1. Disability benefits from Social Security for 24 months

            2. Certain disability benefits from the RRB for 24 months


  • I have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease).
    You automatically get Part A and Part B the month your disability benefits begin. 
    You don't need to sign up if you automatically get Part A and Part B. You'll get your red, white, and blue Medicare card in the mail the month your disability benefits begin.


  • I have End-Stage Renal Disease (ESRD).

If you’re eligible for Medicare because of ESRD, you can enroll in Part A and Part B.

If you qualify for Part A, you can also get Part B. Enrolling in Medicare is your choice. But, you’ll need both Part A and Part B to get the full benefits available under Medicare to cover certain dialysis and kidney transplant services.

When you enroll in Medicare based on ESRD and you’re on dialysis, Medicare coverage usually starts on the first day of the fourth month of your dialysis treatments. This waiting period will start even if you haven’t signed up for Medicare. For example, if you don’t sign up until after you’ve met all the requirements, your coverage could begin up to 12 months before the month you apply.

If you're covered by an employer group health plan, your Medicare coverage will still start the fourth month of dialysis treatments. Your employer group may pay the first 3 months of dialysis.

Medicare coverage can start as early as the first month of dialysis if you meet all of these conditions:

  • You take part in a home dialysis training program offered by a Medicare-certified training facility to teach you how to give yourself dialysis treatments at home.
  • Your doctor expects you to finish training and be able to do your own dialysis treatments.
  • The regular course of dialysis is maintained throughout the waiting period that would otherwise apply.

If you have Medicare only because of permanent kidney failure, Medicare coverage will end:

  • 12 months after the month you stop dialysis treatments.
  • 36 months after the month you have a kidney transplant.

Your Medicare coverage will be extended if:

  • You start dialysis again, or you get a kidney transplant within 12 months after the month you stopped getting dialysis.
  • You start dialysis or get another kidney transplant within 36 months after the month you get a kidney transplant.



For more details click on web link below:

https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b


For a relate blog post, click the web link below:

Do I Need Part A & Part B at Age 65?


1. Source: https://www.medicare.gov/sign-up-change-plans/how-do-i-get-parts-a-b


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How Does Medicare Benefits Work If I Already Have VA Benefits?



How does Medicare benefits work if I also already have VA benefits?

  • Well first of all, Medicare generally does not coordinate with VA benefits. 
  • However you can have both Medicare and VA benefits. Many people choose to use both VA & Medicare benefits in order to have access to more providers and services.
  • Medicare and VA benefits do not work together though. (Medicare generally does not pay for care that you would receive in a VA facility.)
  • For Medicare to cover your care, you generally have to receive care at a Medicare certified facility that works with your Medicare plan coverage.
  • For VA to cover your care, you generally must receive your health care service at a VA facility. However exceptions can be made, for example if you receive prior authorization from the VA to receive VA covered services at a Medicare approved facility. Also if an emergency occurs that requires you to receive care, the VA may cover some of the costs until you can be moved to a VA facility for continued care.
  • Many veterans receive their VA health benefits to get coverage for health care services and items not covered by Medicare. Examples could be: over the counter medications, annual physical exams, and hearing aids, all depending on what current Medicare plan they have.


You may want to consider enrolling in Medicare Part B even if you have VA coverage, since
Part B may cover services you receive from Medicare certified providers and provide you with medical coverage outside the VA health system. Note: Without Part B, you will not have Medicare coverage for physician, outpatient, and ambulance services. Also, if you do not enroll into Part B when you are first eligible to do so, but then later decide to enroll in Part B, you will likely face a Part B premium penalty for each 12 month period you were without Medicare Part B coverage. Lastly, you may also experience gaps in coverage.

Drug coverage offered by the VA is creditable. Which means, it is as good as or better than Medicare Part D prescription drug coverage. So as long as you remain enrolled in drug coverage through the VA, you can delay enrolling in Medicare Part D without penalty. If you are interested in enrolling in a Part D plan in addition to your VA coverage, then compare your options first. Some things to consider are the costs of a plan’s premiums, deductibles, and copays, the drugs that are available on a plan’s formulary (the list of covered drugs), and the pharmacies that you can go to.





Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How Medicare Insurance Plan Is Changing Health Coverage


This Sarasota Herald-Tribune article by Maggie Clark & Barbara Peters Smith explains that changes to Medicare insurance plans can effect your health coverage.

Sometimes due to negotiations between insurance companies and providers such as hospitals, medical groups, or even individual doctors, patients can get caught in between while the insurance companies and providers either work out their differences or worse. (The insurance companies decide to drop those providers and not to accept patients in-network from them going forward.)

There aren’t any rules that stop insurance companies from dropping providers (doctors, medical groups, and hospitals) at any time during the year. So even though you may sign up during the annual enrollment period, your doctors, medical groups, or hospitals can be dropped at any time afterwards! The insured customers need to realize that their providers are not guaranteed to be in-network all year long in a Medicare Advantage Plan.

A Medicare Advantage plan receives a lump sum amount from the government for each enrollee, and reimburses providers in its network at pre-negotiated rates. Insurance companies make profit on any remaining balance after enrollee’s bill are paid.

As a more expensive, but yet a lot more flexible, alternative to an Medicare Advantage plan is to instead purchase both a Medicare Supplement and a Part D (Prescription Drug Plan). Generally most Medicare Supplement plans do not require you to stay in-network and as long as your provider accepts original Medicare then you are also covered with your Medicare Supplement plan. As with anything else, generally to get more flexibility you will pay a higher price. Many Medicare Supplement plans (such as Plan F), don’t have virtually any copays or deductibles. (That is unless you go out of the United States.) You are basically paying a predetermined upfront premium each month. However with Medicare advantage you are basically taking a chance. Even though there are either no premium at all or possibly a very low premium, you may still have copays, coinsurance, deductibles, etc. all which can add up more than a Medicare Supplement total yearly premiums if you become very ill. I kind of relate a Medicare Advantage plan, to a pay as you go type plan.

To read the full article, click on the link below.

http://www.heraldtribune.com/article/20141126/ARTICLE/141129787?Title=How-Medicare-insurance-plan-is-changing-health-coverage


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How Social Security and Medicare Work Together


I read an informative AARP article by Stan Hinden and I thought I’d share the web link below. The article gives a nice overview of how Social Security and Medicare work together.

One question I seem to get a lot is pasted below. He answered this question in his article.

Excerpt:

"Q. When's the right time to apply for Medicare?

A. Medicare generally advises you to apply for coverage during the three months before you turn 65, to ensure it will start in your birthday month. But the full Medicare initial enrollment period lasts for seven months: the three months before the month in which your 65th birthday falls, your birthday month, and the three months afterward. You're free to apply at any time during that period.

If you delay, you may face higher premiums for the rest of your life — 10 percent higher for Part B for every 12 months that you could have had coverage but didn't. But there are important exceptions. If on turning 65 you or your spouse is working for a company with 20 or more employees that covers you under a group health plan, you don't have to enroll in Medicare at that time. You can wait until you stop working or otherwise lose that insurance, and you won't be charged a late enrollment penalty.”1


1. Source: AARP article by Stan Hinden


Click web link below to read entire article:

http://www.aarp.org/work/social-security/info-2015/social-security-medicare-in-retirement.html


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How to Avoid Medicare Land Mines


If you are among the growing number of people still working when you turn 65 and become eligible for Medicare, you may want to read this article from the Wall Street Journal by Ellen Schultz. Click on link below to read.

http://online.wsj.com/article/SB10001424052702303292204577519272250299012.html#printMode


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How To Choose The Right Medicare Plan!



Before I get started with the information below, I just wanted to first mention that: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews



Step 1: Decide if you prefer Original Medicare OR a Medicare Advantage Plan
(Like an HMO or PPO)

Step 2: Decide if you want Prescription Drug Coverage (Part D)

Step 3: Decide if you want supplemental coverage. (This type of supplemental coverage to Original Medicare is also known both as a Medicare Supplement Plan or as a Medigap plan. Two different names for the same thing.)

Some important things to know and other tips to keep in mind: 

  • You first need to be enrolled in both Part A and Part B (Through the Social Security Office) in order to get enrolled in either a Medicare Supplement Plan or a Medicare Advantage Plan. Make sure to enroll in Part B when you are first eligible, or you may face penalties later on if you don’t have creditable coverage.
  • You are not allowed to be enrolled in both a Medicare Advantage plan and a Medicare Supplement at the same time.
  • Many, but not all, Medicare Advantage plans may have drug coverage included in their plan.
  • Many, but not all, Medicare Advantage plans may have zero (or very low) premiums.
  • Many, but not all, Medicare Advantage plans may have dental care, vision, fitness benefits, and even "Over The Counter” (OTC) credits, etc. included in your plan at no extra charge.
  • If you choose a Medicare Supplement (Medigap) plan, you will need to purchase a separate additional Part D Prescription Drug Plan (PDP), if you want drug coverage.
  • If you don’t enroll in a Medicare plan that has Prescription Drug Coverage when you are first eligible and don’t have credible coverage, then later in life if you enroll in a plan with Prescription Drug Coverage, you will incur a 1% per month government penalty for each month you missed from when you were first eligible and that penalty will continue for the rest of your life as long as you keep Prescription Drug Coverage!
  • If you pick a Medicare Advantage plan, be sure to verify that your existing doctors are in the network of specific Medicare Advantage plan that you choose. Also verify that all your prescriptions are covered by the plan and find out your out of pocket costs of each drug.
  • It is important to know what coverage you will have if travel out of your area. All Medicare plans cover you if you have a true emergency. However some HMO plans do not have coverage out of your service area for other things that are not considered true emergencies.
  • Medicare.gov Plan Finder can help you compare Medicare Advantage and PDP plans.
  • If you are still confused or just want some guidance, please contact me to help explain things in simple terms and then enroll you in a Medicare Supplement plan OR Medicare Advantage plan of your choosing after I give you the information you need to make an intelligent decision. If you would like my assistance, please call me at 941-404-5334. By calling this number, I understand I will be directed to a licensed insurance sales agent.






How to Fight a Medicare Claim Rejection


If you are on Medicare or will be soon, this is a very good article from the Wall Street Journal by Anne Tergesen about appealing a no-pay or denied medical claim decision. Worth the read. Click the below link to read the article.

http://www.marketwatch.com/story/how-to-fight-a-medicare-claim-rejection-2012-10-23


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How To Pay Less For Prescription Drugs


I just read several articles with good tips on how to save money on your prescription drugs.

Read the actual articles in web links below to get all their tips.


However below are just some of the tips: (Some tips I feel are common sense. Others are good tips you may not know about!)

  1. Use generics when possible.
  2. Shop around.(Drugs costs can vary by hundreds of dollars at different pharmacies, even within the same town!)
  3. Some warehouse clubs such as CostCo and Sam’s Club tend to have low overall prices and you do NOT need to be a member to get those low prices!
  4. Try smartphone apps (or simply go online if you don’t have a smartphone.)
    Some of the apps or websites you may want to check out are: GoodRx, Blink Health, WeRx.org, and HealthWarehouse.com.
  5. Use Discount cards when not using health insurance. Also instead of just using your insurance, still check to see if the discount card prices are less then your insurance copay or coinsurance amount, and/or deductible.
  6. Ask for free samples from your doctor to help reduce your costs.
  7. Some pharmacies or grocery store chains even offer free generic drugs. (Or at a very reduced cost, anyway!) Generally those types offered for free or reduced cost are some antibiotics and some diabetes medications.
  8. Make sure to “Ask” the pharmacist directly for the cheapest price, including if you didn’t use your insurance, but instead used coupons or discounts. (Note: Many drugstores/pharmacists have a "gag clause” which doesn’t allow them to offer you the cheapest price, unless you ask for it!)
  9. Know your insurance coverage. Find out in advance whether your prescription drug is in your plan’s formulary. Also what tier level your drugs are. Ask your doctor if there is a less expensive drug that does the same thing and is suitable to your needs.
  10. Sometimes, but not always, ordering by mail can be less expensive. Be sure to check, some plans actually charge more for mail ordering though.
  11. Use a pharmacy in your plan’s network. Otherwise, your prescription may not be covered.
  12. If your plan has preferred pharmacies, try to use the preferred pharmacies to save even more money.
  13. Ask your pharmacist and doctor if ordering a larger dosage and then splitting your pills is safe. (Note: Some pills are time released or have other reasons not to split them, so be sure to ask first!)
  14. Patient assistance programs offer free or reduced cost medications to low income, and sometime to the uninsured. Can’t hurt to ask them!


Click on the 4 web links below to read the articles:

How to Pay Less for Your Meds (Consumer Reports)

How to Pay Less for Drugs (AARP)

How to pay less for your prescription drugs, legally (CNN)

10 Expert Tips for Slashing Prescription Drug Costs (MoneyTalkNews)


Sources: Consumer Reports, AARP, CNN, and MoneyTalkNew


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

How To Quickly Research Nursing Homes During The Coronavirus Pandemic


8 On Your Side (WFLA) had a segment on the local evening news that I thought was relevant enough to pass on. Below is their web site with useful information regarding how to quickly research Nursing Homes in Florida during the Coronavirus pandemic.1


Click on web link below to read the 8 On Your Side (WFLA) article with detailed instructions:

https://www.wfla.com/8-on-your-side/florida-coronavirus-how-to-quickly-research-nursing-homes/


Below are some of the web sites they mentioned in the article and on the news:

Federal website: Medicare’s website, Nursing Home Compare
https://www.medicare.gov/nursinghomecompare/search.html?

Florida website: 
https://www.floridahealthfinder.gov/index.html


Department of Health website:
https://floridahealthcovid19.gov/



1. Source: 8 On Your Side (WFLA)


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

If I Am Eligible For Disability Benefits, Do I Automatically Receive Medicare Benefits?


"You generally will receive Medicare benefits after you receive disability benefits for 24 months. When you become eligible for disability benefits, Social Security will automatically enroll you in Medicare.  

Special rules apply to:

End-stage renal disease (permanent kidney failure). People with permanent kidney failure get Medicare beginning:

  • The third month after the month a regular course of renal dialysis begins
  • The month of kidney transplantation
  • Lou Gehrig's Disease (amyotrophic lateral sclerosis). People with amyotrophic lateral sclerosis get Medicare beginning with the month they become entitled to disability benefits.


Note: Residents of Puerto Rico or foreign countries will not receive Part B automatically. You must elect this benefit.” 1


1. Source: AARP


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

IRMAA Income-Related Monthly Adjustment Amount


What is IRMAA (Income-Related Monthly Adjustment Amount)? 

The Medicare Income-Related Monthly Adjustment Amount is an amount you may pay in addition to your Part B premium and/or Part D premium, if your income is above a certain level.1 

The Social Security Administration (SSA) makes initial determinations whether the income-related monthly adjustment amount (IRMAA) applies to Medicare beneficiaries with Part B, or Medicare prescription drug coverage Part D (or both if enrolled in both at the time a determination is made) using IRS data.2

The Social Security Administration (SSA) sets income brackets that determine your (or you and your spouse’s) IRMAA. SSA determines if you owe an IRMAA based on the income you reported on your IRS tax returns two years prior, meaning two years before the year that you started paying IRMAA. The income that counts is the adjusted gross income you reported plus other forms of tax-exempt income.1

To read more on the subject: Click on the 2 web links below:

Initial IRMAA Determination

https://www.medicare.gov/forms-help-resources/mail-you-get-about-medicare/initial-irmaa-determination

Appealing a higher Part B or Part D premium (IRMAA)

https://www.medicareinteractive.org/get-answers/medicare-denials-and-appeals/premium-appeals/appealing-a-higher-part-b-or-part-d-premium-irmaa



1. Source: https://www.medicareinteractive.org/get-answers/medicare-denials-and-appeals/premium-appeals/appealing-a-higher-part-b-or-part-d-premium-irmaa

2. Source: https://www.medicare.gov/forms-help-resources/mail-you-get-about-medicare/initial-irmaa-determination


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Is Medicare Advantage Worth It vs. Traditional Medicare?


I felt this New York Times article by Austin Frakt was very interesting. The article infers from research that Medicare Advantage plans cost about 6% more to the taxpayers, but that Medicare Advantage plans outperform traditional Medicare by offering higher quality.

My personal feelings are that there isn’t one type plan that fits everybody. It really depends on your individual circumstances, budget, current health, and feelings about using in-network doctors, etc. Medicare Advantage may be great for one person, and a Medicare Supplement with a Prescription Drug Plan may be the best option for another person. I never steer my clients towards one type plan or the other. I present their options and let them choose what they feel is best for their particular situation.


To read more, click on the link below.

http://www.nytimes.com/2014/08/19/upshot/medicare-advantage-is-more-expensive-but-it-may-be-worth-it.html?_r=1&abt=0002&abg=0


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

L.B.J. Was Wrong About Medicare Concept


An article from the New York Times by Paula Span regarding when L.B.J. signed Medicare into law in 1965 and now almost 50 years later, Dr. Amy Kelley, has amassed disheartening evidence that L.B.J. was wrong. When President Lyndon B. Johnson signed Medicare into law in 1965, he noted that its benefits to older Americans were not only medical, but financial: “No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime.” Click on the link below to read more.

http://newoldage.blogs.nytimes.com/2012/05/22/l-b-j-was-wrong/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare "Wellness": Worth a Second Look?


These free Medicare "wellness" checkups could end up cutting costs, but it seems they haven't caught on just yet according to this WSJ article by Elizabeth O'Brien. 

If you don't have time to read the whole article, below is an excerpt pulled directly from the article that I thought was important, so Medicare patients know what to expect:

"The new benefit can be confusing to patients, doctors say, because it’s specifically focused on prevention and screenings. It’s also not the same a complete, head-to-toe physical exam. Traditional Medicare still doesn’t fully cover a complete physical; patients are responsible for 20% coinsurance for these exams, an amount that can exceed $100, experts say. (Individual Medicare Advantage programs may fully cover a physical.)

Patients leave their clothes on for the wellness visit, Langston said. While doctors are given leeway to do as much of a “focused” physical exam as they think necessary, it’s likely that a doctor won’t listen to your heart during the wellness visit, nor do many other hands-on procedures. Instead, the doctor or other medical professional will take your blood pressure and record your body mass index. Patients get screened briefly for depression and cognitive impairment, and get a vision test; they also get some vaccines, if needed.

In addition to these screenings, there’s plenty of talk: the patient and doctor will discuss the patient’s medications and medical history and create a customized prevention plan based on a personalized health risk assessment. The two might schedule preventative screenings for the next few years. (Under the Affordable Care Act, screening mammography and colorectal cancer screenings are among the tests now free for beneficiaries, who had to pay coinsurance for these services before.)"1                                          

To read the full article, click on link below.

http://www.marketwatch.com/story/medicare-wellness-visits-worth-a-second-look-2013-02-26?siteid=nwhpf


  1 Source: WSJ article by Elizabeth O’Brien


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare & Healthcare Compare Tools To Help Assist You!


You now have access to expanded decision tools from The Centers for Medicare & Medicaid Services (CMS) via the Internet. You can click directly on the blue hyperlinks to go directly to those web sites.

The Centers for Medicare & Medicaid Services (CMS) launched Care Compare, a streamlined redesign of eight existing CMS healthcare compare tools available on Medicare.gov. Care Compare provides a single user-friendly interface that patients and caregivers can use to make informed decisions about healthcare based on cost, quality of care, volume of services, and other data.

With just one click, patients can find information that is easy to understand about doctors, hospitals, nursing homes, and other health care services instead of searching through multiple tools.

In conjunction with the launch of Care Compare, additional improvements have been made to other CMS data tools to help Medicare beneficiaries compare costs.
The 
Procedure Price Look Up (PPL) tool now includes physician fees in addition to facility fees, offering people with Medicare a more accurate prediction of the true out-of-pocket costs.

Other new tools launched under the eMedicare initiative include:

  • A completely redesigned Medicare Plan Finder Tool for last Open Enrollment;
  • “What’s Covered” app that tells people what’s covered and what’s not in Original Medicare;
  • A price transparency tool that lets consumers compare Medicare payments and copayments for certain procedures performed in both hospital outpatient departments and ambulatory surgical centers;
  • Interactive online decision support to help people better understand and evaluate their Medicare coverage options and costs between Original Medicare and Medicare Advantage;
  • An online service that lets people quickly see how different coverage choices will affect their estimated out-of-pocket costs
  • Webchat option in Medicare Plan Finder helps people get on-the-spot support; and
  • Easy-to-use surveys across Medicare.gov so patients and consumers can continue to offer feedback about their online experiences.


To download the eMedicare Fact sheet that is a .PDF, click on the web link below:

https://www.cms.gov/About-CMS/Story-Page/eMedicare-fact-sheet.pdf


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare & Social Security - Understanding Your Options


Are Medicare & Social Security eligibility ages both the same age? Generally not, since your “Full" Social Security retirement benefit age is normally not the same age as when you are eligible for Medicare!

Social Security’s full retirement age is 66 for most baby boomers!* However you will receive a smaller monthly payout if you decide to sign up at a younger age. You can also opt to further delay signing up for Social Security until you are older, in order to qualify for larger monthly payments later in retirement.

In contrast, the Medicare eligibility age remains 65! So, if you want to wait until 66 or later to claim Social Security, you will need to make sure to sign up for Medicare separately at age 65 to avoid penalties later on.

Below is what you need to know about signing up for Medicare before claiming Social Security:

  1. Social Security and Medicare are separate decisions.
  2. Some people are automatically enrolled in Medicare.
  3. Remember to sign up for Medicare on time.
  4. Signing up for Medicare after you missed the Initial Enrollment Period can trigger penalties.
  5. Beneficiaries who work can avoid the Medicare late enrollment penalty.
  6. Be prepared to get a bill.
  7. Don't wait until age 65 to start researching your Medicare options.


*Click on this Social Security Web link to help figure out your exact full retirement age.

https://www.ssa.gov/planners/retire/retirechart.html

Source: Chart below was cut and pasted from the above Social Security web link.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - AEP (Annual Enrollment Period)


The Medicare Annual Enrollment Period is also sometimes called Annual Election Period and abbreviated as AEP. This year it starts on Oct. 15 and ends on Dec. 7. During this time, Medicare beneficiaries can add, change, or drop Medicare health insurance plans and/or prescription drug coverage for the following year (effective January 1).

If you are satisfied with your current Medicare plan, you don't need to take any action. However, plan details can change annually, so you should compare your plan options to confirm that your health and prescription drug needs are covered by your plan for the next year. This is an important time for beneficiaries to reevaluate their current Medicare Advantage and Medicare Part D Prescription Drug Plan coverage and compare it with the options available in the upcoming year, because effective coverage will be locked in for a calendar year.

Agents can start to talk to clients or prospects about the upcoming year’s plan starting Oct. 1. However agents are not permitted to enroll clients until on or after Oct. 15.

In addition, agents are required to get client’s (or prospect’s) written permission in advance of discussing Medicare Insurance plans per CMS (Centers for Medicare and Medicaid Services) and keep their conversation during that original appointment narrowed down to only Medicare related topics listed on the SOA (Scope Of Appointment) form. The Scope Of Appointment form is designed to protect seniors from unscrupulous agents making Medicare appointments and then on the same appointment trying to sell prospects annuities, life insurance, or other non-Medicare related products instead. If other non-Medicare related products are to be discussed, another appointment needs to be made and discussed during that additional appointment and not on the same Medicare appointment as to comply with CMS rules.

Note: Signing the Scope Of Appointment form does NOT obligate you to enroll in a plan, affect your current enrollment, or enroll in you in Medicare plan.

To read more info from Medicare.gov click on these links:

Medicare Open Enrollment

https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html

Understanding Medicare Part C & Part D Enrollment Periods

https://www.medicare.gov/Pubs/pdf/11219-Understanding-Medicare-Part-C-D.pdf

————————————————————————————————————

Many people ask me what are some of the things I need to look for when comparing Medicare insurance plans against each other?

My suggestion is to check at least the following items:

  • Star Ratings for Medicare Advantage Plans and Prescription Drug Plans.
    (Provided each year by Medicare. Keep in mind that they can change from year to year. The star ratings can be found at Medicare.gov. If you cannot go online, each Medicare insurance plan enrollment guide booklet should also include the updated upcoming year’s Medicare star ratings for that specific plan.)
  • Review the "Benefits at a Glance” or more comprehensive “Summary Of Benefits.” 
    In my opinion, listed below are some of the important (but not limited to) items you should focus on and that you should consider before making a final decision on which plan you choose:
    • What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
    • Annual Out-Of-Pocket Maximum (That is the most you will pay in a year for Medical expenses with a Medicare Advantage plan. Note: This Annual Out-Of-Pocket Maximum amount does NOT include a maximum amount for prescription drugs, even if prescription drugs happen to be included in your plan.)
    • Copays for primary care physicians and also copay amounts for specialists.
    • Inpatient hospital care per day cost and how many days you have to pay.
    • Outpatient surgery cost Find out if the outpatient surgery amount you are responsible for is just a flat amount (copay) or a percentage of the total amount (coinsurance). The amount you are responsible can be different with each plan so be sure to check that out.
    • Emergency Care costs
    • Diagnostic radiology services and diagnostic tests/procedures costs
    • Ambulance
    • Prescription Drugs - Find out if your specific drugs are included in the formulary (complete drug list) of the plan you choose. Then find out the Tier level and/or cost of each of your drugs. Also find out which Pharmacies are in the network and also which are considered preferred Pharmacies for that plan - allowing you to get the least expensive prices.
    • If the Medicare insurance plan you choose has a network. Find out in advance if each of your specific doctors, hospitals, and other providers are in network for that specific Medicare insurance plan.
    • If a fitness program is important to you, find out if a basic gym membership is included in your Medicare insurance plan at no additional cost.
    • Find out in advance if you can travel and still be covered for non-emergency visits to the doctor, etc. with that specific plan. (Note: Almost all the Medicare insurance plans do cover you if it is a true emergency!)
    • Plus there are many other items to compare between plans, so determine what is important to your specific needs before making a decision! Some other options in some plans may or may not include dental and/or vision.



I am an independent insurance agent, certified to handle multiple Medicare insurance companies, allowing me to help you find the Medicare insurance you feel fits your needs. I pride myself in providing excellent customer service to my clients. I will be attentive to your needs and strive to meet or even exceed your expectations for your Medicare insurance needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

If you are confused and/or want more information about which Medicare insurance plan to enroll in, either as a new plan or even if you are just switching to a different Medicare Insurance plan, please call me at 941-404-5334 to set up an appointment to discuss further. If relatively local, I’ll come right at your home, office, or other location.

By calling this number, I understand I will be directed to a licensed insurance sales agent.


Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Annual Enrollment Period (AEP)


Annual Enrollment Period is also sometimes called Annual Election Period and abbreviated as AEP. This year it starts on Oct. 15 and ends on Dec. 7. During this time, Medicare beneficiaries can add, change, or drop Medicare health plans and/or prescription drug coverage for the following year (effective January 1).

If you're satisfied with your current Medicare plan, you don't need to take any action. However, plan details can change annually, so you should compare your plan options to confirm that your health and prescription drug needs are covered by your plan for the next year. This is an important time for beneficiaries to reevaluate their current Medicare Advantage and Medicare Part D Prescription Drug Plan coverage and compare it with the options available in the upcoming year, because effective coverage will be locked in for a calendar year.

Agents can start to talk to clients or prospects about the upcoming year’s plan starting Oct. 1. However agents are not permitted to enroll clients until on or after Oct. 15.

In addition, agents are required to get client’s (or prospect’s) written permission in advance of discussing Medicare Insurance plans per CMS (Centers for Medicare and Medicaid Services) and keep their conversation during that original appointment narrowed down to only Medicare related topics listed on the SOA (Scope Of Appointment) form. The Scope Of Appointment form is designed to protect seniors from unscrupulous agents making Medicare appointments and then on the same appointment trying to sell prospects annuities, life insurance, or other non-Medicare related products instead. If other non-Medicare related products are to be discussed, another appointment needs to be made and discussed during that additional appointment and not on the same Medicare appointment as to comply with CMS rules.

Note: Signing the Scope Of Appointment form does NOT obligate you to enroll in a plan, affect your current enrollment, or enroll in you in Medicare plan.


To read more info from Medicare.gov click on these links:

Medicare Open Enrollment

https://www.cms.gov/Outreach-and-Education/Reach-Out/Find-tools-to-help-you-help-others/Medicare-Open-Enrollment.html

Understanding Medicare Part C & Part D Enrollment Periods

https://www.medicare.gov/Pubs/pdf/11219-Understanding-Medicare-Part-C-D.pdf


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Can I Keep My Marketplace Plan When I’m Enrolled In Medicare?


Question regarding Medicare and Marketplace plans is answered in this Kaiser Health News (KHN) article by Michelle Andrews.

The question was whether one could keep their Marketplace health insurance plan at age 65 or do they have to enroll in Medicare? Technically you don’t have to give up your Marketplace health insurance plan when you turn 65 years old, but financially it doesn’t make sense to keep it. Once a person is eligible for Medicare they will no longer qualify for any premium tax credits on the Marketplace plans, making that coverage more expensive. In addition, one may face higher Medicare premiums in the future if they don’t enroll in Medicare coverage when first eligible.

The penalty for delaying enrolling in Medicare Part B when first eligible could be 10%. In addition, the penalty for delaying enrollment in Medicare Part D when first eligible could be 1% for every month delayed, and the penalties can continue the rest of your life while on Medicare.

To read the entire article, click on the link below.

http://kaiserhealthnews.org/news/can-i-keep-my-marketplace-plan-when-im-enrolled-in-medicare/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Clarification Of When Medicare Should Cover Skilled Care


A very short gist for this issue brief, basically states that Medicare coverage for skilled nursing or therapy is not dependent on a beneficiary’s potential for improving under such care. Instead the coverage depends solely on whether the beneficiary needs the care.

Center for Medicare Advocacy released a new resource on the Medicare Improvement Standard. The issue brief, “Implementing Jimmo v. Sebelius: An Overview,” is intended to provide Medicare stakeholders with an overview of the Jimmo Settlement, what it means in different care settings, and links and references to helpful resource materials.1

In 2013, a federal district court approved a settlement agreement in Jimmo v. Sebelius, No. 5:11-CV-17 (D. VT) agreeing that Medicare coverage for skilled nursing or therapy care is not dependent on a beneficiary’s potential for improving under such care. Instead, the coverage depends solely on whether the beneficiary needs the care. The Jimmo Settlement and later court decisions apply to everyone with Medicare throughout the country, regardless of whether an individual is in traditional Medicare or a Medicare Advantage plan.1


To download read the entire issue brief, click on the web link below:

https://www.medicareadvocacy.org/wp-content/uploads/2019/06/Jimmo-Improvement-Standard-Issue-brief-June-2019.pdf

To read an overview of the Jimmo Settlement, click on the web link below:

https://www.medicareadvocacy.org/new-issue-brief-implementing-jimmo-v-sebelius-an-overview/


1. Source: Medicare Rights Center blog post by Lindsey Copeland


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - How Does Original Medicare Cover Skilled Therapy?


In my opinion, this MedicareRights.org’s "Dear Marci” internet post had a very good explanation regarding what Original Medicare covers for skilled therapy. So I thought I’d share their web link below.

Note: If you have a "Medicare Advantage" plan, your coverage and costs are specific to your own plan and can vary from one Medicare Advantage plan to another. Medicare Advantage plan coverages and costs are generally not the same as Original Medicare alone. 

Previously there was a maximum limit on how much was covered for skilled therapy under Original Medicare. However, did you know that starting in 2018 the therapy cap (maximum allowed to be paid) was removed? Starting in 2018, although once your therapy costs reach a certain amount, Medicare will require your provider to confirm that your therapy is medically necessary.


Click on web link below to read the entire MedicareRights.org internet post.

https://mailchi.mp/medicarerights.org/should-i-change-my-medicare-health-or-drug-plan-this-fall-288137?e=440756ac79


1. Source: Dear Marci - Medicare Rights Center


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - How Does Outpatient vs. Inpatient Effect My Costs?


I was reading some enlightening information from Medicare Rights Center and thought I’d share. It is very important to understand that being classified as “Outpatient” status versus “Inpatient” status can significantly affect your costs that you are directly responsible for paying! You may not even know what the status of your stay in the hospital was classified as until later after you leave, unless you specifically ask!

"When you enter a hospital for treatment you can be classified as an inpatient or an outpatient, and your status affects Medicare costs and coverage. You are an inpatient if your attending physician has formally admitted you as an inpatient. The only way to know if you are an inpatient is to ask, as there are no specific characteristics of your hospital stay that automatically make you an inpatient. For example, an overnight stay in the hospital does not necessarily mean you are an inpatient. In general, doctors will admit you as an inpatient if they expect that you will need to stay in the hospital for medically-necessary, inpatient-level care over two or more midnights.

If you are not formally admitted as an inpatient, then you are considered a hospital outpatient, even if you stay overnight. There are a number of hospital services that are almost always provided as outpatient care, such as an emergency room visit or planned outpatient surgery. 

Observation services, sometimes called observation status, are outpatient services. They include ongoing short-term treatment and assessment of whether you should be admitted as an inpatient or if you can be discharged. Although they may involve an overnight or longer stay, observation services are outpatient services, so it is important to ask your doctor about the services you receive and what your hospital status is. Since observation services are provided to you as an outpatient, your coverage and costs will be different from the coverage and costs if you were an inpatient.”1


Click on the web link below to read more about coverage and costs if you stay in the hospital overnight:

https://www.medicareinteractive.org/get-answers/medicare-covered-services/hospital-services-outpatient-part-b/coverage-and-costs-if-you-stay-in-the-hospital-overnight


1. Source: Dear Marci - Medicare Rights Center (www.medicareinteractive.org)


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - How To Choose A Plan

Contact me as an independent agent and I can help you understand your choices and assist you choosing a plan.

Note: It doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have the benefit of personalized service by a local agent to help answer your questions. 
If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.


PS: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you understand your options, let you choose a plan that you feel fits your needs the best, and then enroll you in the plan you choose.


Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


With that said above, if you still would like to research on your own first and also read a couple of informative AARP articles, click on the web links below. These articles are regarding "how to choose a Medicare plan" and if you plan on enrolling in a Medicare Supplement, "how to choose the right Medicare Supplement plan," (Also known as Medigap plans).

How To Choose A Medicare Plan

How To Choose The Right Medicare Supplement Plan



Medicare - How to Navigate the Part D Coverage Gap


Some tips and information to help navigate the Part D coverage gap.

  • The Part D coverage gap is also know as the “Donut Hole!”
  • The Part D coverage gap is a payment stage with Medicare prescription drug plans when the main cost burden for prescription drugs shifts from the insurance plan to the plan member.
  • There are 4 different stages you need to be aware of:
    • Deductible Stage (You pay the full amount of your drugs until you satisfy your annual prescription deductible amount)
    • Initial Coverage Stage (You pay your plan’s copay or coinsurance for the specific tier levels of each of your drugs)
    • Coverage Gap Stage (You pay a higher percentage amount of your drug costs until you reach the next stage.)
    • Catastrophic Coverage Stage (After reaching this stage, you pay a reduced amount for your drugs until the end of the year. Then you start the cycle all over again.)
  • Each of the above Part D payment stages (except the last) has a dollar limit that marks when you exit that stage and enter the next. You move through the Part D payment stages based on how much is spent on your drugs throughout the year.


Tips for Navigating the Coverage Gap

It’s best to avoid the coverage gap all together, if you can! 

Plan ahead by getting an estimate of the following:

  • Try to determine what your yearly drug costs may be with your Part D plan
  • Try to determine if (and also when) you might reach the coverage gap
  • Try to determine when you would exit the coverage gap. 

Your out-of-pocket drug costs are reduced once you’re out of the gap and in the catastrophic coverage stage.

Search your plan choices.

Talk to your doctor about your options for using generic or low cost drugs rather than brand name or high price drugs. Make sure to ask your doctor about this and other ways to lower your drug costs. If you enter the coverage gap, your doctor may help you find ways to get through quickly. Your costs will be much lower once you reach the catastrophic payment stage.

Track your drug costs. Your plan should send you a statement each month that gives you important information. It’s called an Explanation of Benefits. This statement lists the prescriptions you filled that month with details about what you paid, what your plan paid and any other payments on your behalf from programs or organizations.

Ask for help. There are programs and organizations that may be able to help if you can’t afford your medications, no matter what payment stage you’re in. Usually you need to qualify based on your income and other financial resources.



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents ReviewsTips for Navigating the Coverage Gap

Medicare - If You Care About Cost Control, Don’t Let Them Change It To Premium Support!


I have read yet another article regarding this same topic and thought I’d share it.

This particular MarketWatch article by Alicia H. Munnell is entitled, "If you care about cost control, don’t mess with Medicare.” You can find a web link to it below.


Excerpt from article:

"Speaker of the House Paul Ryan is proposing a big change to Medicare as part of the broad-ranging Better Way plan.  Under the current Medicare program, the government provides health insurance for people 65 and over and adults with disabilities.  Under the Better Way plan, the government would provide a voucher, and the elderly and disabled would select a plan from a private insurer. Speaker Ryan argues that this change will help make the Medicare program more fiscally stable.”1 

With the current Medicare system, Medicare beneficiaries have a guaranteed set of benefits. Replacing those guaranteed set of benefits with a fixed dollar amount (via a voucher), the Medicare beneficiaries would be responsible for the remaining amounts not covered by the vouchers.

"Under the voucher plan, the government can keep its costs low by limiting the size of the voucher, but that strategy would only lead to an enormous financial burden falling on vulnerable elderly and disabled individuals.”1 

Additionally in the article, it goes on to mention that Medicare spending grows more slowly than private insurance spending.


To read the entire article click on web link below:

http://www.marketwatch.com/story/if-you-care-about-cost-control-dont-mess-with-medicare-2017-01-09

1. Source: MarketWatch article by Alicia H. Munnell entitled, "If you care about cost control, don’t mess with Medicare. "http://www.marketwatch.com/story/if-you-care-about-cost-control-dont-mess-with-medicare-2017-01-09


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Is It Going Bankrupt Or Not?


A recent blog post dated Dec. 5, 2016 on the Center on Budget Policy Priorities by Paul N. Van de Water (Senior Fellow Director, Policy Futures) addressed a common false myth about the financial footing of Medicare and that it was going bankrupt. However he wrote that Medicare is not running out of money.

The Center on Budget Policy Priorities writes: 
"Medicare’s Hospital Insurance (HI) trust fund will remain solvent - that is, able to pay 100 percent of the costs of the hospital insurance coverage it provides - through 2028, the program’s trustees wrote in their latest report. Even after 2028, when the HI trust fund is projected for depletion, incoming payroll taxes and other revenue will still cover 87 percent of Medicare hospital insurance costs. 

Policymakers will need to close this shortfall by raising revenues, slowing the growth in costs, or most likely both, as they’ve done many times before.  But Medicare’s hospital insurance program will not run out of all financial resources and cease to operate after 2028, as 'bankruptcy' suggests.

The 2028 date doesn’t apply to Medicare coverage for physician and outpatient costs or to the Medicare prescription drug benefit, neither of which faces insolvency. They’re financed through the program’s Supplementary Medical Insurance (SMI) trust fund, which consists of two separate accounts - one for Medicare Part B, which pays for physician and other outpatient health services, and one for Part D, which pays for outpatient prescription drugs. Premiums for Part B and Part D are set each year at levels that cover about 25 percent of costs; general revenues pay the remaining 75 percent. Therefore, SMI can’t run short of funds.”1


To read the entire blog post from Center on Budget Policy Priorities (CBPP) click on the web link below:

http://www.cbpp.org/blog/to-repeat-medicare-isnt-going-bankrupt


1. Source: http://www.cbpp.org/blog/to-repeat-medicare-isnt-going-bankrupt
Paul N. Van de Water (Senior Fellow Director, Policy Futures) Dec. 5, 2016


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Medicare Advantage Plans Are Not The Same As Medicare Supplement Plans


One type of plan doesn’t fit everybody’s needs. A Medicare Supplement plan may be good for one person, but on the other hand a Medicare Advantage plan may fit better for somebody else. However you are not allowed have both a Medicare Supplement and Medicare Advantage plans at the same time.

It is very important that you understand the difference between Medicare Supplement plans and Medicare Advantage plans BEFORE enrolling. This is a common area of confusion among seniors first starting out in Medicare, and even some seniors that have been enrolled in a Medicare plan for a some time. There are major differences between Medicare Supplement plans and Medicare Advantage plans.


Medicare Advantage Plans:

  • Medicare Advantage comprises a variety of private health plans. Instead of still having Original Medicare, like with a Medicare Supplement, Medicare Advantage plans are administered through private insurance companies. However every Medicare Advantage plan must cover at least all the same benefits (or more) than Original Medicare Part A and Part B covers.
  • A Medicare Advantage plan is a separate insurance policy administered by a private  insurance company that replaces original Medicare Part A (Hospital) and Part B (Doctor visits/Medical).
  • After joining a Medicare Advantage plan, the Medicare Advantage plan (administered by a private  insurance company, not the government) will handle all claims and provide all your Medicare Part A and Part B coverage. 
  • Medicare Advantage plans can be more restrictive than Medicare Supplement plans, but they generally have very low premiums and many even have zero premiums. 
  • Many Medicare Advantage plans can also include prescription drug coverage all in the same plan, at no additional premium cost.
  • Unlike Medicare Supplement Plans, most Medicare Advantage plans have a network.
  • Each Medicare Advantage plan may have different networks and different formularies (drug lists). Make sure you (or your agent) look up every single one of your doctors to make sure they are in-network and also search to verify that all your prescription drugs are in the formulary for the specific plan you choose. (Note: Even within the same insurance company, networks and formularies can differ from plan to plan!)
  • With Medicare Advantage HMO plans you need to go to providers in-network or you are not covered, unless a true emergency. Also with many HMO plans you need to get a referral from your primary care physician to go to a specialist.
  • With Medicare Advantage PPO plans you have a little bit more flexibility and can go out of their network, but it will cost you more for the privilege.
  • With both Medicare Advantage HMO & PPO plans you can have copays, coinsurance, and deductibles that you may be responsible for. Be sure you understand each plan and that you review the one you choose very carefully before enrolling in it. 
  • Many (but not all) Medicare Advantage HMO & PPO plans include prescription drug coverage in the same plan at no additional premium. However there is a formulary (drug list) for each plan. If your prescription drug is not in the formulary, it is not covered.
  • Medicare Advantage HMO & PPO plans have an annual out-of-pocket maximum. This is kind of a safety net, so your medical expenses don’t exceed that amount in one year. It resets every year though. (Keep in mind that your prescription drug copays, coinsurance, and deductible are not included in that annual out-of-pocket maximum amount. Only your medical expenses are included.)
  • Medicare Advantage plans can also have additional benefits that Original Medicare does not. Each plan can be different, but some could include vision or dental benefits, etc


Medicare Supplement Plans:

  • Medicare Supplement plans do not replace original Medicare, but instead they add on to it (like a gap filler). So a Medicare Supplement basically adds to the benefits already covered by Original Medicare.
  • With a Medicare Supplement plan, private insurance companies can cover all or part of your Medicare "out of pocket expenses," depending on which Medicare Supplement plan you choose.
  • If you choose a Medicare Supplement plan you will still be covered by Original Medicare. Medicare Supplement plans just compliment Original Medicare. So if Original Medicare doesn’t cover a procedure, neither will your Medicare Supplement plan.
  • New Medicare Supplement plans do not cover prescription drugs. (If you want prescription drug coverage, you will need to purchase an additional separate plan, known as Part D.)
  • You can go to any doctor in the U.S. as long as they take Medicare. (No Networks)
  • Along with that extra flexibility, there is generally more cost. Premiums can be much higher for a Medicare Supplement versus a Medicare Advantage plan and as I mentioned above if you want prescription drug coverage you will still need to purchase a Part D plan in addition to the Medicare Supplement premium.
  • Even within the Medicare Supplement plans, there are many Plans to choose from, identified by Letters. (These Medicare Supplement “Plan” letters are different from the Medicare “Part" Letters, such as Part A, B,C, and D.) So don’t get confused.
  • In Florida (and most states except Mass., Minn. and Wisc.) each Medicare Supplement plan letter has to be standardized from one insurance company to another. (For example, when shopping one insurance company plan against another, Medicare requires the plans to be standardized. So really the only main differences from one insurance company’s Medicare Supplement to another (with the same plan letter) will be the premium amount, and possibly any additional benefits on top of the standardized benefits. Also when comparing Medicare Supplement companies, keep in mind the percentage of their previous annual increases from one company to another, to get an approximate idea of possible future increase percentages. Also ask how is their customer service and ability to pay claims on time.



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare - Mistakes!


I read an informative AARP Bulletin article by Patricia Barry and I thought I’d share the top 10 Medicare mistakes they mentioned to be aware of:

  1. Assuming you don't qualify if you haven't worked long enough
  2. Failing to enroll in Part B when you should
  3. Believing you don't need Medicare Part B if you have retiree or COBRA health coverage
  4. Thinking you must reach full retirement age before signing up
  5. Not signing up for Part D because you don't take any prescription drugs
  6. Misunderstanding enrollment periods
  7. Picking a Part D drug plan on the basis of its premium or its name or because your best friend chose it
  8. Being too late to buy medigap with full protections
  9. Failing to read your Annual Notice of Change
  10. Not realizing that you may qualify for help to lower your costs


However for more information on each of the bullet points above, read the entire article by clicking the web link below:

http://www.aarp.org/health/health-insurance/info-2014/medicare-mistakes-to-avoid.html

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Click on link below for another related blog post:

Medicare Enrollment Mistakes Can Be Costly


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - New "What's Covered” Mobile App



Are you unsure if Medicare will cover a medical test or procedure? The Center for Medicare and Medicaid Services ("CMS") has a new app available to help answer those questions. However I’m pretty sure it won’t cover everything, but it might be a handy resource, especially for those of you that are on either Original Medicare and/or a Medicare Supplement. However those of you that are on a "Medicare Advantage" plan, it is still best to call your provider’s member services phone number listed on the back of your member card to determine what is and is not covered under your specific plan.

The app is called "What's Covered" and is available for free on both the App Store and Google Play. So you may want to download it onto your mobile device and check it out.

The app delivers cost and coverage information right on your smartphone.
Search for "What's Covered" or "Medicare” at the app store (for Apple devices) or at Google Play (for Android devices) and download the app to your phone.

The app delivers general cost, coverage, and eligibility details for items and services covered by Medicare Part A and Part B. Search or browse to learn what's covered and not covered, how and when to get covered benefits; and basic cost information. You can also get a list of covered preventative services.


Click on the link below to read more about the What's Covered app directly on Medicare.gov.

https://www.medicare.gov/blog/whats-covered-mobile-app


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Part D - When To Enroll & More


When to enroll in Part D:

When you become eligible for Medicare, you may sign up for Part D (Prescription drug coverage part of Medicare), as soon as you are enrolled in either Medicare Part A or Part B. Although you do not necessarily have to sign up for Part D if you choose not to, but you may face a late enrollment penalty if you do not sign up when you are first eligible. However, if you have creditable coverage, you can delay signing up for Part D and will not have to pay a late enrollment penalty.

Keep in mind some, but not all, Medicare Advantage plans include Part D combined in with their benefits. With most Medicare Advantage plans you cannot have both a Medicare Advantage plan and a separate stand alone Part D plan. 

You would only choose to enroll in a stand alone Part D plan if you decided to go with original Medicare and a Medicare Supplement plan OR just original Medicare alone.

What is creditable coverage?

It is coverage that on average is as good as or better than the Medicare drug benefit offered through Part D. You should receive notice from your plan or employer every year informing you whether your drug coverage is creditable for Part D. If you do not receive this notice, you should contact your plan or employer’s benefits administrator. 

Creditable coverage can be from:

  • Current employer coverage from you or your spouse
  • Former employer coverage from you or your spouse, such as retiree insurance
  • Federal Employee Health Benefits
  • Military coverage, such as TRICARE for Life (TFL) or Veterans’ Affairs (VA) benefits


Note: If you currently have creditable coverage that you like, you may want to keep it. since if you join a Medicare prescription drug plan, you may lose your creditable drug coverage and be unable to get it back later. Ask your employer or benefits administrator what will happen to your other drug coverage if you join a Part D plan.

For more information on Part D click on the web link below.

https://www.medicare.gov/part-d/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews



Medicare - Questions To Ask When Enrolling


Where do I call or visit to enroll in Medicare or just ask questions:

You can visit your local Social Security Office or you can call the National Social Security Hotline at 800-772-1213. The locations of Social Security Offices can be found by clicking this web link www.ssa.gov


Questions to ask when enrolling into Medicare:

Keep in mind Medicare coverage is divided into parts. (See related web links below.)

  1. When will my Medicare coverage begin?
  2. What will I be paying for Medicare coverage?
  3. How will I pay for my Part B premium?
  4. How will Medicare work with any other health coverage I have?


Questions to ask when you have another type of insurance coverage:

Note: Only people covered by large group health plans from current employers can delay Medicare Part B enrollment without paying a late enrollment penalty.
Examples: 
a) If you are 65 or over and have a large group health plan that your (or your spouse’s) employer employs 20 or more employees. 
b) If you have Medicare due to a disability and have a large group health plan that your (or your spouse’s) employer employs 100 or more employees.

  1. Will my current insurance coverage allow me to delay Medicare enrollment?
  2. When should I enroll into Medicare if I am delaying now?
  3. How will delaying enrollment now affect when I can enroll into Medicare in the future?
  4. How will delaying enrollment now affect my Medicare premium later?
  5. What information and documents will I need to provide to Social Security when I do enroll into Medicare?


Note: if you visit a Social Security Office, ask for a receipt that reflects the your visit. If you call Social Security, ask the representative to send you a record of your call. Always, write down the representative’s name, the date, the time of day and what the representative said.


Click On Related Web Links:


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Shopping For A Medicare Insurance Plan


Many people ask me what are some of the things I need to look for when comparing Medicare insurance plans against each other?

My suggestion is to check at least the following items:

  • Star Ratings for Medicare Advantage Plans and Prescription Drug Plans.
    (Provided each year by Medicare. Keep in mind that they can change from year to year. The star ratings can be found at Medicare.gov. If you cannot go online, each Medicare insurance plan enrollment guide booklet should also include the updated upcoming year’s Medicare star ratings for that specific plan.)
  • Carefully review the "Benefits at a Glance” and/or the more comprehensive “Summary Of Benefits” . In my opinion, some of the important (but not limited to) items to focus on and that should be considered before making a decision on which plan you choose are:
    • What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
    • Annual Out-Of-Pocket Maximum (That is the most you will pay in a year for Medicare care provided by the plan. Note: This Annual Out-Of-Pocket Maximum amount does NOT include a maximum amount for prescription drugs, even if prescription drugs happen to be included in your plan.)
    • Copays for primary care physicians and also copay amounts for specialists.
    • Inpatient hospital care per day cost and how many days you have to pay.
    • Outpatient surgery cost (Find out if that outpatient surgery amount you are responsible for is just a plan flat copay amount or a percentage of the total amount?)
    • Emergency Care costs
    • Diagnostic radiology services and diagnostic tests/procedures costs
    • Ambulance
    • Prescription Drugs - Find out if your specific drugs are included in the formulary (complete drug list) of the plan you choose. Then find out the Tier level and/or cost of each of your drugs. Also find out which Pharmacies are in the network and also which are considered preferred Pharmacies for that plan - allowing you to get the least expensive prices.
    • If the Medicare insurance plan you choose has a network. Find out in advance if each of your specific doctors, hospitals, and other providers are in network for that specific Medicare insurance plan.
    • If a fitness program is important to you, find out if a basic gym membership is included in your Medicare insurance plan at no additional cost.
    • Find out what additional benefits, such as dental, vision, hearing, or even if there may be an allowance for "Over The Counter Drugs” is included with the plan you are considering.
    • Find out in advance if you can travel and still be covered for non-emergency visits to the doctor, etc. with that specific plan. (Note: Almost all the Medicare insurance plans do cover you if it is a true emergency!)
    • Plus there are many other items to compare, so determine what is important to your specific needs before making a decision!



I am an independent insurance agent, certified to handle multiple Medicare insurance companies, allowing me to help you find the Medicare insurance you feel fits your needs. I pride myself in providing excellent customer service to my clients. I will be attentive to your needs and strive to meet or even exceed your expectations for your Medicare insurance needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

If you are confused and/or want more information about which Medicare insurance plan to enroll in, either as a new plan or even if you are just switching to a different Medicare Insurance plan, please call me at 941-404-5334 to set up an appointment to discuss further. If relatively local, I’ll come right at your home, office, or other location.

By calling this number, I understand I will be directed to a licensed insurance sales agent.


Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Should I Keep My Existing Medicare Insurance Plan Or Switch To A New Plan?


It all comes down to a personal decision on what you feel fits your needs the best. There isn’t one magical plan that fits everybody’s needs the best!

Some important questions and items you should ask or review with an *independent" agent before switching plans are listed below. 

*I added the word “independent” since independent agents can offer multiple insurance companies giving you more flexibility and choices than just a captive agent that only works for one insurance company.

  • Star Ratings for Medicare Advantage Plans and Prescription Drug Plans.
    (Provided each year by Medicare. Keep in mind that they can change from year to year. The star ratings can be found at Medicare.gov. If you cannot go online, each Medicare insurance plan enrollment guide booklet should also include the updated upcoming year’s Medicare star ratings for that specific plan.)
  • Carefully review the "Benefits at a Glance” and/or the more comprehensive “Summary Of Benefits.” 
    In my opinion, some of the important (but not limited to) items to focus on and that should be considered before making a decision on which plan you choose are:

    • What type of Medicare insurance plan is it? Medicare Advantage HMO, Medicare Advantage PPO, or a Medicare Supplement with perhaps an additional stand alone drug plan. (PDP)
    • Annual Out-Of-Pocket Maximum (That is the most you will pay in a year for Medical care provided by the plan. Note: This Annual Out-Of-Pocket Maximum amount does NOT include a maximum amount for prescription drugs, even if prescription drugs happen to be included in your plan.)
    • Copays for primary care physicians and also copay amounts for specialists.
    • Inpatient hospital care per day cost and how many days you have to pay.
    • Outpatient surgery cost (Find out if that outpatient surgery amount you are responsible for is just a plan flat copay amount or a percentage of the total amount?)
    • Emergency Care costs
    • Diagnostic radiology services and diagnostic tests/procedures costs
    • Ambulance
    • Prescription Drugs - Find out if your specific drugs are included in the formulary (complete drug list) of the plan you choose. (Note: Each specific plan can have a different formulary, even if they are with the same insurance carrier.) Then find out the Tier level and/or cost of each of your drugs, plus what the annual drug deductible will be (if any). Also find out which Pharmacies are in the network and also which are considered preferred Pharmacies for that plan - allowing you to get the least expensive prices.
    • If the Medicare insurance plan you choose has a network. Find out in advance if each of your specific doctors, hospitals, and other providers are in network for that specific Medicare insurance plan.
    • If a fitness program is important to you, find out if a basic gym membership is included in your Medicare insurance plan at no additional cost.
    • Find out what additional benefits, such as dental, vision, hearing, or even if there may be an allowance for "Over The Counter Drugs” is included with the plan you are considering.
    • Find out in advance if you can travel and still be covered for non-emergency visits to the doctor, etc. with that specific plan. (Note: Almost all the Medicare insurance plans do cover you if it is a true emergency!)
    • Plus there are many other items to compare, so determine what is important to your specific needs before making a decision!





Click on web link below for related blog post:

Medicare Insurance Plan Choices for this Upcoming Annual Enrollment Period



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare - Social Security Expands Online Medicare Enrollment Process


The Centers for Medicare & Medicaid Services (CMS) and the Social Security Administration (SSA) recently expanded the functionality of the Medicare enrollment process to accommodate more online applications during the coronavirus pandemic.1

Previously, only people applying for Medicare Parts A and B at the same time could use the online portal. People who were already enrolled in Part A and were using a Special Enrollment Period (SEP) or seeking Equitable Relief to enroll in Part B had to submit documentation to SSA in person or via fax—an option made available during the current public health emergency.1

Under the modernized system, people who are eligible for a Part B SEP can now apply online. To qualify for this enrollment window, either they, their spouse, or sometimes a family member, must currently have or have recently lost a job that provided health insurance. Applicants must also upload proof of this job-based coverage, to show they have been consistently insured since becoming Medicare-eligible.1

Click web link below to read entire article:

https://www.medicarerights.org/medicare-watch/2020/06/11/social-security-administration-expands-online-medicare-enrollment-process-on-ssa-gov?utm_source=Medicare+Rights+Center


1. Source: https://www.medicarerights.org/medicare-watch/2020/06/11/social-security-administration-expands-online-medicare-enrollment-process-on-ssa-gov?utm_source=Medicare+Rights+Center

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Steps On How To Enroll In Medicare Insurance Plans


  • If you want to enroll in a Medicare insurance plan (such as a Medicare Supplement or a Medicare Advantage Plan), then the first step is to be enrolled in both Part A and Part B through the Social Security office. 

  • If you do not already receive Social Security benefits when you turn 65, you must to apply for Medicare yourself. You can make an appointment at your local Social Security office to enroll or you can even enroll directly online at https://secure.ssa.gov/iClaim/rib . 
    However if you already receive Social Security benefits when you turn 65, the federal government will automatically enroll you in Medicare. You should not need to sign up for Medicare and your Medicare will start on the first of the month that you turn 65. Click this link to read related blog post

    To avoid penalties, you must enroll during your Initial Enrollment Period. Your Initial Enrollment Period includes the three months before your 65th birthday, the month of your 65th birthday, and the three months following your 65th birthday. If you enroll in Medicare during this seven month period, you can avoid late enrollment penalties and gaps in health insurance coverage.

    The Part B premium will be automatically deducted from your Social Security check. However, if for some reason you choose that you don’t want Part B you can contact the Social Security office and opt out of it. (Keep in mind there will be penalties later on if you decide you want to enroll in Part B later on in life and you didn’t enroll when you were first eligible.)

  • Once you are eligible, you can then pick the Medicare insurance plan and insurance company that you personally feel will best accommodate your needs. There are a variety ways of choosing Medicare Insurance plans, but it can be quite confusing and overwhelming doing all the research yourself. That is the time where you may want to choose an independent agent that carries multiple carriers to assist you. (Please Note: Independent agents are paid directly by the insurance company if you enroll through the agent. Commissions and fees are NOT paid to the agents by the clients’ themselves. Also keep in mind that independent Medicare insurance agents do not work directly for the Federal government.)

  • Gist: So if you enroll online or by phone directly with the insurance company, it will still cost you the same as enrolling with an independent agent, but without the benefit of a local independent agent explaining things in depth to you personally. Also by enrolling directly with an independent agent such as myself, you will get the benefit of a local person explaining Medicare to you in person on a one-on-one basis in your home, office, or other location, as well as explaining different Medicare insurance plans from different insurance companies, answering all your questions, and then also being here locally if you have questions, etc. after you are enrolled. With all the extra benefits of using a local independent agent to enroll you in a Medicare insurance plan at no additional cost to you, it is really a no-brainer to enroll through an independent agent. Call me at 941-404-5334, if I can assist you.



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare - The 5 Most Asked Questions Since The Election


I read this informative AARP Bulletin January/February 2017 article and thought I’d share it.

Below are the five most asked questions regarding Medicare since the election and some partial answers:

  1. I’m already on Medicare. Could I really lose my coverage or see it radically altered?
    For people currently on Medicare, there is no immediate threat to your coverage. The most widely discussed plan proposed by House Republicans would not go into effect until 2024.1 (For full answer click below to read entire article.)


  2. Reforming Obamacare seems to be an important early goal of the Trump administration. How could that affect my Medicare coverage? 
    The ACA made a number of improvements to Medicare—including closing the gap in drug coverage (the “doughnut hole”), adding free preventive benefits and cutting excess provider payments—that improved the financial stability of the program….If the entire health care law is repealed, these improvements would be lost.1 
    (
    For full answer click below to read entire article.)

  3. Isn’t Medicare at risk of going broke within a few decades? For the sake of grandkids, don’t we have to make some changes?
    Medicare is not going broke: The program can pay full hospital benefits through 2028.1 
    (
    For full answer click below to read entire article.)

  4. I’ve heard about the voucher-type plan that House Republicans hope to implement soon. How would this plan change Medicare?
    The “premium support” plan put forward by House Republicans represents a dramatic change: It would move away from guaranteed benefits and instead provide older adults with a set amount of money (similar to what has been called a voucher) to buy health insurance from private companies.1 
    (
    For full answer click below to read entire article.)

  5. I’ve been paying payroll taxes for Medicare for many years and thought I was guaranteed coverage. Can the rules be changed now before I’m old enough for Medicare?
    Current benefits are set in law for today’s beneficiaries. But Congress can revise the law at any time to change the benefit guarantee, raise the age of eligibility and require higher cost sharing.1 
    (
    For full answer click below to read entire article.)


To find out the answers to the above questions, click on the web link below:

http://www.aarp.org/politics-society/advocacy/info-2016/why-medicare-matters-key-questions-answered.html?CMP=EMC-SNG-ADV-MED-012617&cmp=NLC-ADVOCATE-0117&autologin=true


1. Source: AARP Bulletin January/February 2017 “The 5 Most-Asked Questions” article on page 38.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - What Do I Need To Do To Enroll?


You need to enroll in Medicare on time or you could face penalties. The appropriate steps you need to take to enroll in Medicare on time will differ depending upon whether or not you already collect Social Security retirement benefits when you turn 65 or not. 

If you already receive Social Security benefits when you turn 65, the federal government will automatically enroll you in Medicare. You should not need to sign up for Medicare and your Medicare will start on the first of the month that you turn 65. 

However on the other hand, if you do not already receive Social Security benefits when you turn 65, you must to apply for Medicare yourself. To avoid penalties, you must enroll during your Initial Enrollment Period. Your Initial Enrollment Period includes the three months before your 65th birthday, the month of your 65th birthday, and the three months following your 65th birthday. If you enroll in Medicare during this seven month period, you can avoid late enrollment penalties and gaps in health insurance coverage.

The date your Medicare coverage begins depends on when you enroll during your Initial Enrollment Period. For your coverage to begin as soon as possible, it is best to enroll in the first three months of your Initial Enrollment Period (that is the three months before the month you turn 65). Your Medicare coverage will then go into effect starting the first day of the month you turn 65. If you enroll during the month you turn 65, your Medicare coverage will go into effect the following month. If you enroll during the fifth month of your Initial Enrollment Period, your Medicare coverage begins two months after you enroll. If you enroll during the sixth or seventh month of your Initial Enrollment Period, your coverage begins three months after you enroll.

To enroll in Medicare, you can call the Social Security Administration at (800) 772-1213, or you can enroll online, or you can visit your local Social Security office.

When you enroll in Medicare (either actively during your Initial Enrollment Period or automatically), you receive Medicare Parts A and B. Most people do not pay a premium for Part A, but almost all people owe a premium for Part B. That Part B premium can be deducted directly from your Social Security benefits if you already receive them.


Click link below to read more about enrolling in another related blog post:

Medicare: When To Enroll


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

  

Medicare - What Happens If You Missed Your Initial Enrollment Period?


Did you have employer insurance through a current job or your spouse’s job at the time you became eligible for Medicare?


If yes:

You may be eligible for a "Special Enrollment Period," which means you can enroll in Medicare without penalty at any time while you have group health coverage and also for 8 months after you lose your group health coverage or you (or your spouse) stop working, whichever comes first. 


If no:

You can apply for Medicare during the General Enrollment Period, between January 1 and March 31 of each year. Your coverage will start the following July and you will have to pay a Part B premium penalty. 


Note: It is best to contact the Social Security office find out information for your specific situation.

Social Security (800-772-1213)
www.ssa.gov/pgm/reach.htm


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - What Is A Formulary?



A formulary is a list of prescription drugs that are covered in a stand alone Medicare Prescription Drug plan (Part D) or Medicare Advantage plan (Part C) that has prescription drug coverage included. (Note: Not all Medicare Advantage plans have prescription drug coverage included.) 

Each Medicare Prescription Drug plan (Part D) and Medicare Advantage plans, that have prescription drug coverage, have their own specific formularies. If your prescription is not in the formulary of the Medicare Insurance plan you choose, then it is not covered. So it is very important to look up all your prescriptions within the specific plan you choose in advance before you decide to enroll in that specific plan. Formularies can not only vary just from one insurance company to another insurance company, but also can vary within the same company by different plans. So don’t assume all your drugs are covered just because your drugs were listed in the formulary of an insurance company in one plan, but then you decide to switch to another plan within the same company. Since they could have a different formulary for that other plan even though it is through the same insurance company and possibly some of your drugs may not be covered under that different plan. In addition, even if all your drugs are covered in one plan and are also still covered in another plan you choose, verify the tier levels for each of your drugs are the same. Tier levels can vary from one plan to another. Many Medicare Insurance plans place drugs into different tier levels within their formularies. Drugs in each tier level can have different costs. Generally the lower the tier level, the lower the copay for the member, with some exceptions. Be sure to find out the tier level and copays for each of your drugs. Also check to see if there is a deductible in your drug plan and if so, how much. Since some plans (but not all) require you to pay a deductible for your drugs before any drug benefits kick in. 


For more information, click on the link below:

https://www.medicare.gov/part-d/coverage/part-d-coverage.html


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - What Is A Medigap Policy?


Many American’s are totally confused when becoming eligible for Medicare on what their options are and then which plans to choose from. All the TV ads, newspaper ads, and even the abundance of US Mail you receive still doesn’t clarify the subject and sometimes even adds to the confusion. Additionally many folks already on Medicare still really don’t know what type plan they have or their options to change plans.

A “Medigap” policy is basically just another name for a "Medicare Supplement” policy.

A Medicare Supplement (Medigap) policy is a standardized supplemental health plan that pays for part or all of Medicare related health care costs that you would otherwise pay out of pocket if you just had Original Medicare. Medicare Supplement policies only work with Original Medicare Parts A and B, which is Medicare coverage through the federal government. So need to have Part A & Part B first if you want to enroll in a Medicare Supplement policy.
Note: If you plan to get your Medicare benefits through a private insurance company, called a Medicare Advantage Plan (also known as Medicare Part C), then you cannot additionally purchase a Medicare Supplement policy. To be very clear, you cannot legally have both type policies at the same time.

Medicare Supplement policies “supplement" Original Medicare costs. Those type of out of pocket costs can include deductibles, coinsurance charges, and copays). Medicare Supplement policies do not usually pay for items not covered directly by Medicare. However, some Medicare Supplement policies do cover some emergency care received in foreign countries, which is typically not covered by Medicare.  

Medicare Supplement policies are regulated by each state, usually under a department of insurance or a similar state agency. This means that some aspects of Medicare Supplement policies work differently in each state. Medicare Supplement policies are still subject to some federal regulations, but different states may have their own Medicare Supplement rules as well.

There are different types of Medicare Supplement policies that you can purchase. Private insurance companies can offer ten standardized Medicare Supplement policies in most states: Plans A, B, C, D, F, G, K, L, M, and N. Note that insurance companies do not have to offer all ten Medigap policies. 

Important Note: Plans with the same letter offer the same benefits, but each insurance company may charge a different monthly premium. Meaning that you can get the same exact coverage even if you choose the exact same letter plan with a lower monthly premium from a different insurance company. So it is best to shop around to get the lowest premium with an insurance company that is reputable and pays their claims on time. Also it is important to review the history of the past years increases for any company you are considering enrolling with. Some Medicare Supplement insurance companies have had very minimal increases while others may have had large annual increases. So although the past doesn’t always predict the future, it is a good guide to help you decide.


Related Topics:

Click web links below to read:

Medicare - Medicare Advantage Plans Are Not The Same As Medicare Supplement Plans

Medicare - What Is The Difference Between Medicare Supplement And Medicare Advantage Plans


I am an independent insurance agent, certified to handle multiple Medicare insurance companies, allowing me to help you find the Medicare insurance you feel fits your needs. I pride myself in providing excellent customer service to my clients. I will be attentive to your needs and strive to meet or even exceed your expectations for your Medicare insurance needs.

So if you are confused and/or want more information about which Medicare insurance plan to enroll in, either as a new plan or even if you are just switching to a different Medicare Insurance plan, please call me at 941-404-5334 to set up an appointment to discuss further. If relatively local, I’ll come right at your home, office, or other location.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.


Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - What Is A Scope Of Appointment Form & Do I Have To Sign One?


There are many rules and regulations that were set up by the CMS (Centers for Medicare and Medicaid Services) to help protect seniors. One is the Scope Of Appointment form.

Agents are not permitted to come to your house without an invitation. A “Scope Of Appointment” form is required to be signed by prospective clients in advance of an agent discussing their Medicare Insurance plan options. (A Scope Of Appointment form is basically just your written permission for an agent “only" to discuss the Medicare plan options listed on that form. This type of form was designed to help protect seniors from unscrupulous agents making Medicare appointments, then showing up just to sell Life Insurance, Annuities, or other unrelated products that may be more profitable for them.)

All Medicare appointments must follow the scope of appointment form options that you agreed to and signed before discussing Medicare. The scope of the appointment lists what you specifically want to discuss at the appointment whether it is a Part D plan, a Medicare Advantage Plan, or a Medicare Supplement (also known as a Medigap) plan. The agent is not allowed to talk to you about other products that are not included in the scope of the appointment. If there is another unrelated Medicare product topic to be discussed, the agent will need to make another appointment with you to discuss that topic at a later date and time.

However keep in mind by signing a Scope Of Appointment, it still does NOT obligate you to enroll in a plan. It is just giving your permission to discuss your Medicare Insurance plan options.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - What Is ANOC And How Does It Affect You?


ANOC is an abbreviation for Annual Notice Of Change.

The Annual Notice of Change (ANOC) may be considered the most important mailing you'll receive from your Medicare plan each year, and you should definitely read it.

If you are currently enrolled in a Medicare Advantage Plan or a stand-alone Part D prescription drug plan, then you should receive a plan "Annual Notice of Change" (ANOC) and/or *Evidence of Coverage (EOC) from your plan each fall no later than September 30. If you do not receive an ANOC from your plan by the first week of October you should call your plan’s member service phone number on the back of your member ID card.

The ANOC notices include a summary of any changes to your plan’s list of covered drugs (known as a formulary), copays, coinsurance, deductibles, other health benefits, and premium costs that will be effective January 1st of the next year. It is important for you to read your mail from your plan to see if there are any changes that may affect you. The fact is that almost every plan makes some changes for the new year, so the costs and benefits in place on December 31 may well be dramatically different on January 1. Review any changes to decide whether the plan will continue to meet your needs in the next year.


*Evidence of Coverage is a more comprehensive list of the plan’s cost and benefits for the upcoming year.

 



Note: If you feel your current plan will not meet your needs for the upcoming year, feel free to call me at 941-404-5334 to set up an appointment where we can review some different plans together that you feel may fit your needs better.

All this Medicare information can be overwhelming and confusing to many people. As an independent licensed agent I can explain all this to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a different plan that you feel may fit your needs better.

By the way, it doesn’t cost you any more if you enroll through me as an independent agent versus directly with an insurance company either over the phone or via the Internet since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - What Is The Difference Between Medicare Supplement And Medicare Advantage Plans


One type of plan doesn’t fit everybody’s needs. A Medicare Supplement plan may be good for one person, but on the other hand a Medicare Advantage plan may fit better for somebody else. However you are not allowed have both a Medicare Supplement and Medicare Advantage plans at the same time.

Below I list some of the main differences between a Medicare Supplement versus a Medicare Advantage plan:


Medicare Supplement (Also known as Medigap):

  • With a Medicare Supplement plan, private insurance companies can cover all or part of your Medicare "out of pocket expenses," depending on which Medicare Supplement plan you choose.
  • If you choose a Medicare Supplement plan you will still be covered by Original Medicare. Medicare Supplement plans just compliment Original Medicare. So if Original Medicare doesn’t cover a procedure, neither will your Medicare Supplement plan.
  • New Medicare Supplement plans do not cover prescription drugs. (If you want prescription drug coverage, you will need to purchase an additional separate plan, known as Part D.)
  • You can go to any doctor in the U.S. as long as they take Medicare. (No Networks)
  • Along with that extra flexibility, there is generally more cost. Premiums can be much higher for a Medicare Supplement versus a Medicare Advantage plan and as I mentioned above if you want prescription drug coverage you will still need to purchase a Part D plan in addition to the Medicare Supplement premium.
  • Even within the Medicare Supplement plans, there are many Plans to choose from, identified by Letters. (These Medicare Supplement “Plan” letters are different from the Medicare “Part" Letters, such as Part A, B,C, and D.) So don’t get confused.
  • In Florida (and most states except Mass., Minn. and Wisc.) each Medicare Supplement plan letter has to be standardized from one insurance company to another. (For example, when shopping one insurance company plan against another, Medicare requires the plans to be standardized. So really the only main differences from one insurance company’s Medicare Supplement to another (with the same plan letter) will be the premium amount, and possibly any additional benefits on top of the standardized benefits. Also when comparing Medicare Supplement companies, keep in mind the percentage of their previous annual increases from one company to another, to get an approximate idea of possible future increase percentages. Also ask how is their customer service and ability to pay claims on time.


Medicare Advantage Plans (Also known as Part C):

  • Medicare Advantage comprises a variety of private health plans. Instead of still having Original Medicare, like with a Medicare Supplement, Medicare Advantage plans are administered thru private insurance companies. However every Medicare Advantage plan must cover all the same benefits, or more, than Original Medicare covers.
  • Medicare Advantage plans can be more restrictive than Medicare Supplement plans, but they generally have very low premiums and many even have zero premiums. 
  • Many Medicare Advantage plans can also include prescription drug coverage all in the same plan, at no additional premium cost.
  • Unlike Medicare Supplement Plans, most (but not all) Medicare Advantage plans have a network. 
  • With Medicare Advantage HMO plans you need to go to providers in-network or you are not covered, unless a true emergency. Also with many HMO plans you need to get a referral from your primary care physician to go to a specialist.
  • With Medicare Advantage PPO plans you have a little bit more flexibility and can go out of their network, but it will cost you more for the privilege.
  • With both Medicare Advantage HMO & PPO plans you can have copays, coinsurance, and deductibles that you may be responsible for. Be sure you understand each plan that you review carefully before choosing to enroll in one. 
  • Many (but not all) Medicare Advantage HMO & PPO plans include prescription drug coverage in the same plan at no additional premium. However there is a formulary (drug list) for each plan. If your prescription drug is not in the formulary, it is not covered.
  • Medicare Advantage HMO & PPO plans have an annual out-of-pocket maximum. This is kind of a safety net, so your medical expenses don’t exceed that amount in one year. It resets every year though. (Keep in mind that your prescription drug copays, coinsurance, and deductible are not included in that annual out-of-pocket maximum amount. Only your medical expenses are included.)
  • Medicare Advantage plans can also have additional benefits that Original Medicare does not. Each plan can be different, but some could include vision or dental benefits, etc.



Note: All this Medicare information can be overwhelming and confusing to many people. As an independent licensed agent I can explain all this to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll through me as an independent agent versus directly with an insurance company either over the phone or via the Internet. Since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - What Providers, Prescriptions, Medical Procedures, Etc. Are Covered Under My Medicare Insurance Plan?



Each Medicare Insurance Plan type covers different things, and even the same type plan in a different area may cover different things and/or at different out of pocket expenses. It is important to have your insurance agent that enrolls you in a plan explain what your Medicare Insurance Plan covers, and also make sure that all your doctors and prescriptions are covered under your Medicare Insurance plan you choose “before" signing up.

If you are confused after you already have enrolled in a Medicare Advantage plan you should call the member services toll free phone number on the back of your member ID card and ask the phone representative your questions. They should be able to tell you if your doctor is in network, if your prescriptions are covered, if a medical procedure is covered, as well as the amount your copays, coinsurances, or deductibles, if applicable for your procedures. Also they can look up what Pharmacy is in network and which Preferred Pharmacies will save you the most on your specific drugs.

For those with a Medicare Supplement, most plans will allow you to go to any doctor in the U.S. that takes Medicare. However there are some select Medicare Supplements plans that require you to use in network “hospitals." You can also call the member services toll free phone number on the back of your member ID card if you have any questions on your Medicare Supplement Plan. Keep in mind that you will need to have a separate Prescription Drug Plan if you want your prescription drugs covered, since none of the newer Medicare Supplement plans include prescription drug coverage.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - When Turning 65, Should I Sign Up Or Not?


When is the right time for you individually to enroll in Medicare? It all depends on your individual circumstances. See below for some tips:


  • Don’t miss Medicare deadlines for enrolling, or it could cost you big time in late enrollment penalties later on when you do decide to enroll. In most cases, the penalty payment sticks with you once you enroll and carries on for as long as you have the coverage. 
  • Part B: The late enrollment penalty is 10 percent of the Part B premium amount for each full 12-month period you delay enrollment past your eligibility month.
  • Part D: When you finally do enroll in Part D, the late enrollment penalty is 1% for every month you missed once you were eligible for Part D, if you delayed enrolling at that time, and didn’t have credible coverage.
  • Important Take Away: Even if you delay your retirement beyond the age of 65, it doesn’t necessarily mean you should also delay making Medicare decisions and dealing with Medicare enrollment.



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Which Insurance Is Primary? (Medicare Or Employer Coverage?)


There are many factors that determine whether Medicare is primary (pays first) or secondary (pays second) and it will depend on your specific situation.

If you have Medicare and other health insurance or coverage, each type of coverage is called a "payer." When there's more than one payer, "coordination of benefits" rules decide which one pays first. The "primary payer" pays what it owes on your bills first, and then sends the rest to the "secondary payer" to pay. In some cases, there may also be a third payer.

Medicare can either be primary or secondary to your employer coverage. This coverage usually depends on the size of the employer and whether or not you or your spouse are currently working.

Primary insurance pays first for health care claims. Secondary insurance pays after the primary insurance for some or all of what the primary insurance did not cover. Knowing which is your primary insurance is important to understand because secondary insurance often refuses to pay anything if the primary insurance has not paid first.

You should consult with to your employer to find out how your employer insurance will work with Medicare.

Generally if you are 65 or over and still have insurance through your (or your spouse’s) current employer that has 20 or more employees, then your employer coverage is primary. However with that said, if you have insurance coverage through your (or your spouse’s) current employer that has fewer than 20 employees, then Medicare is primary.

For other situations, please click on the web link below

How Medicare coordinates with other coverage

https://www.medicare.gov/supplement-other-insurance/how-medicare-works-with-other-insurance/how-medicare-works-with-other-insurance.html




Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare - Why You Do NOT Want To Miss These Deadlines!


Very informative Money video and article with experts Larry Kotlikoff and Phil Moeller explaining about the most important things you should know.

Be warned, that there may be a very, very short political advertisement preceding the video that you can choose to ignore. However the content after that ad is worth the wait.

By enrolling in Medicare during the appropriate deadlines, you can avoid penalties that can follow you the rest of your life if you miss them!


Click the web link below to view the video and entire article.

http://time.com/money/4363233/medicare-deadline-social-security/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Advantage Appeal Outcomes


Something important to know, it can really pay to appeal a Medicare Advantage denial of coverage since chances are good the denial will be overturned if the claim is legitimate. 

When beneficiaries and providers appealed preauthorization and payment denials, Medicare Advantage Organizations (MAOs) overturned 75 percent of their own denials during 2014 to 2016 according to a report from the Office Of Inspector General (OIG).

During the same 
period, independent reviewers at higher levels of the appeals process overturned additional denials in favor of beneficiaries and providers.1

Beneficiaries and providers rarely used the appeals process, which is designed to ensure access to care and payment. During 2014 to 2016,
beneficiaries and providers appealed only 1 percent of denials to the first level of appeal.1

When Medicare Advantage beneficiaries and providers appealed, they were usually successful in getting denials overturned!1

So bottom line: If you feel you have had a legitimate Medicare Advantage claim denied, file an appeal! You should be able to contact your Medicare Advantage customer service via the phone number on the back of your member card to find out the process to appeal for your specific plan and company.

1. Source: Report in Brief U.S. Department of Health and Human Services, September 2018 OEI-09-16-00410 (Office of Inspector General)


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Advantage Plans - Pros and Cons


No one type of Medicare Insurance plan fits everybody the same. What may work best for one person, may not work very good for another person. It is a personal choice for you to decide, but it is important to get all the facts first before making a decision. However it is also important to pick the correct plan that fits your needs, since not all Medicare Advantage plans have the same benefits. It is important to review the Summary of Benefits before picking a specific plan.

If you currently have health insurance, you probably already have some similarities of a Medicare Advantage plan, such as a PPO or HMO plan. There are some major differences as well.

Medicare Advantage plans are administered through private insurance companies and not through the government like Original Medicare is.

I’ll start with some of the Pro’s of a Medicare Advantage plan and then list some of the Con’s.


Pro’s

  • Many Medicare Advantage plans have a $0 monthly premium!
  • Many Medicare Advantage plans do not have a Medical deductible!
  • Many Medicare Advantage plans include drug coverage in the same plan with no additional monthly premium.
  • Medicare Advantage plans have to give you at least the same (or more) Part A and Part B benefits than what Original Medicare allows you for Part A or Part B benefits.
  • Medicare Advantage plans may include additional benefits that Original Medicare and/or Medical Supplements may not, such as:
    • Dental Benefits
    • Vision Benefits
    • Hearing Benefits
    • Fitness Memberships At Gyms
    • Nurse Helplines (Available 24 hours a day & 365 days a year)
    • Heath Screening Tests
    • Over The Counter (OTC) Benefits
  • All Medicare Advantage plans have a Maximum Annual Out Of Pocket Limit
  • Emergency Room coverage within the U.S., even if out of network.
  • Medicare Advantage plans cover Urgently Needed and Emergency Services Worldwide! (Original Medical generally doesn’t cover emergency services out of the U.S.) 
  • Medicare Advantage PPO plans allow you the flexibility to go out of network, but you will pay more to do so. However if you stay in-network, generally you will have lower costs.
  • Some plans allow you to travel in other states and still be covered in-network.
  • Medicare Advantage plans generally try to keep the emphasis on heather living and preventive care.
  • Medicare Advantage plans must enroll any eligible beneficiary who applies regardless of health. (Starting 2021 - Including those with ESRD!)
  • Some Medicare Advantage plans may cover additional days of hospitalization vs Original Medicare.
  • Some Medicare Advantage plans may cover skilled nursing and rehabilitative services without a prior 3 day inpatient Hospital stay. 


Con’s

  • Most Medicare Advantage plans have a network of doctors.
    Note: HMO’s require you to use a provider in-network or you are NOT covered. (With the exception of a true emergency. All Medicare Advantage plans cover true emergencies, even if out of network.) PPO plans have more flexibility allowing you to go out of network, but you will pay more if you do.
  • Your favorite doctors possibly may not be in-network. That is why it is important to make a list of your doctors and have your agent look all of them up in the specific plan you choose before enrolling. That way you shouldn’t have unpleasant surprises later in the year.
  • You need to be living in a Medicare Advantage plan service area in order to enroll in a specific Medicare Advantage plan. If you move out of that service area later, you will be required to change plans.
  • You are required to be enrolled in Part A and Part B in order to be enrolled (and stay enrolled) in a Medicare Advantage plan. So you will still need to continue to pay Part B premiums to the government.
  • Not necessarily a con, but just like stand alone Part D plans, Medicare Advantage plans that include drugs have a formulary. (A formulary is a list of drugs covered under that specific plan.) If your drugs are not included in their formulary for the plan you choose, they won’t be covered. So it is important for you or your agent to check in advance to make sure all your drugs are covered and estimate how much each will cost.
  • Most Medicare Advantage plans have copays, co-insurance, and possibly deductibles. So you kind of pay as you go. 
  • Generally, unless you have a special circumstance that qualifies you for a Special Election Period (SEP) you can be locked in for one year in the plan you chose.



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Alphabet 101 For Beginners - What Do All Those Letters Actually Mean?


Let's start with the basics:

There are four Medicare “Parts.”

  • Part A (Gives you help with hospital costs)
  • Part B (Gives you help with doctor’s care and outpatient care) 
  • Part C (Medicare Advantage Plans)
  • Part D (Prescription Drug Plans)


Side Note: Letters are also used for different types of Medicare Supplement Plans, so don’t get the “Part" letters and “Plan" letters confused! They are for totally different things!


Part A: Hospital Insurance
(Includes skilled nursing facilities or hospice, and some home health care.)

For more details on Part A, click on this link


Part B: Medical Insurance
(Includes doctor services, outpatient care, durable medical equipment and some preventive services.) 

For more details on Part B, click on this link


Part C: Medicare Advantage

Medicare Advantage plans are offered by private insurance companies as an alternative to Original Medicare; plans are government subsidized and regulated. A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. 

If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most Medicare Advantage plans (but not all) include Medicare prescription drug coverage (Part D).

For more details on Medicare Advantage plans, click on this link

To learn more about costs for Medicare Advantage Plans, click on this link


Part D: Prescription Drug Coverage

Part D Plans are offered by private companies to provide coverage for prescription drug costs; plans are government subsidized and regulated.

For more details on Part D, click on this link

======================================================================

Medicare Supplement Plans

A Medicare supplement (Medigap) insurance policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

For more details on Medicare Supplements (Medigap) click here.

Source: Medicare.gov

These are some of the Medicare Supplement Benefit Plan Letters that may possibly be available. Plans A, B, C, (High Deductible Plan C), D, F, (High Deductible F), G, K, L, M, N. However, not all plans may be available in your state and not all plans are offered by every insurance company.


Related Blog Posts:

  1. Medicare Questions - Plans, Parts, & More
  2. Medicare - When To Enroll
  3. Medicare – What Do I Need To Do To Enroll?
  4. Medicare - Questions To Ask When Enrolling
  5. Medicare - Part A & Part B - Do I Have To Sign Up Or Does That Happen Automatically?
  6. Medicare Part D - When To Enroll & More


External web link to Reader’s Digest Glossary of Medicare Terms and definitions.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Beneficiaries Taking Plan Selection Seriously


This Benefitspro article written by Kathryn Mayer, mentions that according to a recent Humana survey of a 1,000 Medicare eligible residents, the carrier found that people eligible for Medicare coverage are taking the plan selection process “very seriously.”

The article goes on to mention that Medicare beneficiaries who research and evaluate Medicare options spend, on average, 22 hours on their plan decision — “reflecting the importance they place on the decision,” Humana said.

The survey also found that 64 percent of people eligible for Medicare cite plan quality as the key factor driving them to switch their Medicare coverage, rating overall quality as more important than plan cost and ability to continue receiving care from their primary care provider. To read more, click the link below.

http://www.benefitspro.com/2013/11/14/medicare-beneficiaries-taking-plan-selection-serio


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Benefit Periods - Learn How They May Affect You!


A benefit period is how the Original Medicare program measures your use of inpatient hospital and also your skilled nursing facility services. A Medicare benefit period begins the day that you enter a hospital or skilled nursing facility and then ends when you have not received inpatient hospital or Medicare covered skilled care in a skilled nursing facility for 60 days in a row. Please note that the benefit period is not tied to the calendar year. 

If you go back into the hospital or a skilled nursing facility after one benefit period has ended (more than 60 days after you left), a new benefit period begins. There is no limit to the number of benefit periods you can have, or how long a benefit period can be.  

Benefit periods also affect how much you may pay for your inpatient hospital or skilled nursing facility stay. You must meet your Part A deductible at the beginning of each benefit period as well as pay a daily coinsurance depending on how many days you stay at the hospital or skilled nursing facility during one benefit period.  

After you meet your Part A deductible at the beginning of the benefit period, the first 60 days of your inpatient hospital stay are covered with no daily coinsurance. Likewise, if you qualify for a Medicare-covered skilled nursing facility stay, you will pay nothing for the first 20 days of your skilled nursing facility stay within a benefit period.  

In 2016, Original Medicare Part A costs for hospital and skilled nursing facility stays are:

  • Deductible: $1,288 for each benefit period
  • Hospital coinsurance: $0 for the first 60 days of inpatient care each benefit period; $322 per day for days 61-90
  • Skilled nursing facility coinsurance: $0 for the first 20 days of inpatient care each benefit period; $161 per day for days 21-100  


Click on web link below to read related article:

Medicare Part A, Benefit Periods, and Deductibles


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Benefits Won't Be Affected By Obamacare's Health Insurance Marketplace


Are you a senior on Medicare or about to be on Medicare and confused about this new Obamacare's (Affordable Care Act) Health Exchanges and how it will affect you? If so, this USA Today article by Susan Jaffe from Kaiser Health News is for you! 

It states that Medicare is taking steps to help seniors understand that their benefits won't be affected by the Affordable Care Act's Health Insurance Marketplace. "We want to reassure Medicare beneficiaries that they are already covered, their benefits are not changing and the marketplace doesn't require them to do anything," said Michele Patrick, Medicare's deputy director for communications. To read more, click on the web link below.

http://www.usatoday.com/story/money/business/2013/08/24/medicare-health-insurance-marketplace/2692977/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Choices Tricky Even For Med Students, Doctors


In this Reuter's article by Kathryn Doyle, it was interesting to find that even med students and doctors had a difficult time choosing the least expensive Medicare Part D plans, according to a recent study. The article went on to say that their results reinforce the notion of ‘choice overload' where the more options we have, the more difficulty we have processing and comparing the attributes of these options and making a decision. Click the web link below to read more.

http://www.reuters.com/assets/print?aid=USBRE99E0QI20131015


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Drug Prices - Negotiations Act Would Lower Costs


I read this informative Medicare Rights Center blog post by Julie Carter (dated 10-26-17) and thought I’d share it.


Pasted below is an excerpt:

"Currently, the HHS Secretary is not allowed to negotiate drug prices in the Medicare program, though drug prices are negotiated in the Medicaid program as well as in the U.S. Department of Veterans Affairs.”1

Can you believe that in this day and age that Medicare Drug Costs (with all the volume and clout of the U.S. government) are still not allowed to be negotiated, even though other departments of the U.S. government such as, Medicaid and the VA, are allowed to negotiate prices? No wonder the prescription drugs costs have skyrocketed for Medicare prescription drugs over the last several years!

Click on link below to read entire article.

The Medicare Drug Price Negotiation Act Would Lower Costs and Preserve Care


Click on link below to read just the fact sheet.

Fact Sheet



1. Source: https://blog.medicarerights.org/medicare-drug-price-negotiation-act-lower-costs-preserve-care/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare Enrollment Mistakes Can Be Costly


In this MartketWatch article by Glenn Ruffenach, he mentions mistakes that can be costly to seniors. 

Some examples would be missing deadlines, which may lead to life time penalties, higher health care costs, or coverage gaps.

The article also mentions that seniors who are working beyond age 65 and delaying Social Security benefits, which means more individuals are likely to encounter problems with Medicare enrollment.

Some suggestions to tackle these issues recommended by The Medicare Right Center are:

  • Enhanced Education
  • Changes in enrollment periods
  • Stronger avenues for relief
  • Additional research.


Click on link below to read the full article.

http://www.marketwatch.com/story/medicare-enrollment-slip-ups-are-costly-for-retirees-2014-11-17 


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Fraud - What You Can Do To Help Prevent It


I read some interesting AARP articles regarding Medicare fraud and thought I’d share. 


Below are some excerpts:

"Each year, roughly 10 cents of every dollar budgeted for the giant health insurance program is stolen or misdirected before it helps any enrollee. Looked at another way, about $1,000 is lost per Medicare member through theft or waste each year. That is according to the federal government’s reckoning. But it could be far worse. Malcolm Sparrow, a Harvard University professor and leading expert on health care fraud, says the true amount lost to fraud, abuse or improper payments could be 20 percent, or even as high as 30 percent.”1

It’s not just taxpayers who pay the price. Medicare beneficiaries also foot the bill in the form of higher deductibles and copayments, and cuts to services and care. Put simply, fraud is directly harming the health of older Americans and compromising the program.”1

"Fraudsters often:

Charge for services never delivered
Falsify records
Inflate claims
Steal your ID
File duplicate claims
Provide unneeded equipment
Buy off doctors/patients
Shortchange your care" 1


Below are just a few of the tips they suggested to protect yourself:

  • "Review your Medicare Explanation of Benefits statements. Verify that each of the items on your statement was provided on the date listed and from the provider indicated. 
  • Call the Medicare hotline at 800-633-4227 if you have questions about your statement or think an adjustment is in order. 
  • Report it to authorities if you spot a charge that does not look legitimate or if you become aware of what appears to be fraudulent Medicare activity. The contact is the hotline at the HHS Office of Inspector General, 800-447-8477. All calls are handled confidentially. If you suspect there is a fraudulent charge to your prescription plan (Medicare Part D), the toll-free number to call is 877-772-3379.
  •  Write a letter with any complaints to: U.S. Department of Health and Human Services Office of Inspector General, Attention: OIG Hotline Operations, P.O. Box 23489, Washington, D.C. 20026.
  •  Alert the government: Health care providers who know of fraud or waste should report it by calling 800-447-8477.”2



To read the articles, click on the web links below.

  1. https://www.aarp.org/money/scams-fraud/info-2018/medicare-scams-fraud-identity-theft.html
  2. https://www.aarp.org/money/scams-fraud/info-2018/medicare-fraud-identity-theft-scam.html
  3. https://www.aarp.org/money/scams-fraud/info-2018/medicare-strike-force.html
  4. https://www.aarp.org/money/scams-fraud/info-2018/how-to-avoid-medicare-scams.html


1. Source: AARP Bulletin April 2018 - Cover Story Fraud - Medicare Under Assault Page 10,
https://www.aarp.org/money/scams-fraud/info-2018/medicare-scams-fraud-identity-theft.html

2. Source: AARP Bulletin April 2018 - Medicare Fraud: Taking A Stand Page 22, https://www.aarp.org/money/scams-fraud/info-2018/how-to-avoid-medicare-scams.html



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Fund To Be Exhausted 2 Years Sooner Than Estimated!


I just read this brief MarketWatch article by Steve Goldstein dated June 22, 2016 that states that the Medicare Hospital Insurance Trust Fund will have sufficient funds to cover its obligations until 2028, two years earlier than previously projected, trustees announced Wednesday.


Click links below to read brief articles:

http://www.marketwatch.com/story/trustees-say-medicare-fund-to-be-exhausted-two-years-sooner-than-estimated-2016-06-22

More info:

http://www.marketwatch.com/story/social-security-medicare-funds-face-insolvency-over-20-years-report-finds-2016-06-22


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare ID Number Change



New Medicare ID numbers (also known officially known as a Medicare Beneficiary Identifier or MBI) were issued removing your social security number from your Medicare Beneficiary Identifier Card. (Note: The new Medicare ID number replaced your old Medicare ID number that previously included your social security number, followed by a letter or two.)

The transition period started April 1, 2018 and ran through December 31, 2019.

The main reasons they took the SSN off of Medicare cards was to fight medical identity theft for people with Medicare and also to help protect their privacy.

Don’t worry though, your Medicare benefits were not changed by the new Medicare ID number.


For more information, click on web links below:

https://www.cms.gov/Medicare/New-Medicare-Card/index

For a downloadable PDF:

https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/MedicareCard-FactSheet-TextOnly-909365.pdf



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare Insurance Plan Choices - Annual Election Period


OK, AEP (Annual Election Period) has arrived. Now what do you do?

Below are some tips I recommend:

  • Determine if you have been satisfied this past year with your existing Medicare Insurance plan.
  • If not, you should definitely shop around for a new Medicare Insurance plan.
    Note: Even if you have been satisfied, due to changes from one year to the next year your benefits may not be the same as they were this past year. So it is still prudent to check out what is available for the upcoming year in other plans and compare that to what your plan will offer in the upcoming year as well.
  • The next step to shop around would be to go to Medicare.gov to compare which plans offer the least expensive out of pocket expenses for your specific needs. You’ll need to type in your local zip code, the type of plan you are looking for, all your prescription drugs, including doses, how many times a day you take them, and your preferred pharmacies for a more accurate comparison.
  • Once you found some of the plan choices you like, then depending on whether you are looking for a Medicare Advantage Plan or just a stand alone Prescription Drug Plan:
    1) For a Medicare Advantage Plan you’ll also need to include searching within that plan’s network to determine if all your doctors or other providers are in their network for that specific plan, search your prescription tier levels for that plan, as well as check to see if the pharmacies you plan on using are preferred pharmacies in their network.
    2) For a Prescription Drug Plan you should include determining if the pharmacies you plan on using are preferred in-network pharmacies. Also check to determine the tier levels of each of your drugs.
  • Check out the star ratings for each plan you are interested in.
  • Finally after you have been educated with all that information, you’ll have a much better chance of making a good decision.
  • If you need assistance in making your Medicare Insurance plan decision, an “independent” agent (an agent that carries multiple insurance companies) is the way to get the information you need without any additional charge to you, since agents get paid directly by the insurance companies for enrolling clients. That way you will get the benefit of their knowledge and experience without costing you an extra dime!


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Do Agents Charge Clients Fees?

This is a common question I am asked as an independent insurance agent. The answer is that independent agents are paid directly by the insurance carrier if you enroll and NOT by the clients’ themselves. (Please Note: Independent Medicare insurance agents do not work directly for the Federal government.)


For more information regarding if agents charge fees, click on web link below to read blog post:

Medicare Insurance Plans - Do Agents Charge Clients Fees?

Medicare Insurance Plan Choices for this 2021 Annual Enrollment Period


There are many new Medicare Insurance plan choices for this upcoming 2021 as well as several changes to some of the existing plans. So if you haven’t reviewed your options yet or don’t plan on reviewing them this annual election period, you may be missing out! Please contact me at 941-404-5334 to set up an appointment for a review of your existing Medicare insurance plan versus some of the new Medicare insurance plan options. As an independent agent, I can show (and explain to you in simple terms), several different insurance company plans so you can compare and choose which you feel fits your needs the best.

Note: It doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent.

The Medicare Annual Enrollment Period (abbreviated as AEP), starts on Oct. 15 and ends on Dec. 7. During this time, Medicare beneficiaries can add, change, or drop Medicare health insurance plans and/or prescription drug coverage plans for the following year (with an effective date of January 1, 2021).

If you are totally satisfied with your current Medicare plan, you don't need to take any action. However, please keep in mind that Medicare Advantage plan details can change annually, so you should really compare your existing Medicare Advantage plan to confirm that your health and prescription drug needs are covered by your plan for the next year. This is an important time for beneficiaries to reevaluate their current Medicare Advantage and Medicare Part D Prescription Drug Plan coverage and compare it with the new plan options available for 2021, because coverage will be locked in for a calendar year even if you just renew your existing Medicare Insurance plan. 


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll you in a plan that you feel fits your needs.

As I mentioned above, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Insurance Plan Choices Matter


I read a interesting Hearld-Tribune article about Medicare by Barbara Peters Smith, so I thought I’d share it. If you would like to read the entire article, click the web link below.

One of the main take away points I found to be interesting was this sentence below:

"All the tricky decisions involved in signing up for Medicare can be daunting — which is why only 13 percent of beneficiaries, on average, bother to switch their plans during the open-enrollment period each fall.”1

As an independent insurance agent that handles different insurance carriers, I take care of new clients with a personal touch including patience. I thoroughly explain different Medicare insurance plan options available to them. Then after explaining, I have them choose which Medicare Insurance plan they feel best fits their needs.

Then later on even to this day, as a courtesy during AEP (Annual Enrollment Period), I still try to call all my existing Medicare clients each year to give a brief overview of changes in their Medicare insurance plans from their current year to the upcoming year and ask if they are still happy with their existing insurance plan.

It is important to review your Medicare insurance plan for changes from year to year. What might have been good last year for you may not necessarily still be good for you the upcoming year.


Please click web link below to read entire article:

http://www.heraldtribune.com/news/20161002/as-medicare-market-evolves-choices-matter 


1. Source: Hearld-Tribune article by Barbara Peters Smith dated Oct 2, 2016


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


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Related Topic:

Click on web link below to find out answer.

Medicare Insurance Plans - Do Agents Charge Clients Fees?

Medicare Insurance Plans - Do Agents Charge Clients Fees?


Do Agents Charge Clients Fees?

This is a common question I am asked as an independent insurance agent. The answer is that independent agents are paid directly by the insurance carrier if you enroll and NOT by the clients’ themselves. (Please Note: Independent Medicare insurance agents do not work directly for the Federal government.)

Your premiums will be exactly the same whether you enroll online, or submit an application via US Mail, versus enrolling with an independent agent. However, if you enroll with an independent agent you get the extra benefit, at no additional cost, of a face to face meeting where an experienced independent agent can present and explain impartially the different insurance companies Medicare insurance plans; such as Medicare Advantage, Medicare Supplements, and Medicare Prescription Drug plans. Additionally you can get your questions answered at that time as well. I generally present several different Medicare insurance plans, unless the clients requests a plan by name specifically, but I never steer my clients towards one plan or another. After I present the choices I carry, I let them choose what they feel is best for their particular circumstances. One particular plan doesn’t fit all. It is an individual choice that best fits your needs.   

With that said above, since independent agents are only compensated based on whether you enroll with them or not, I usually mention to my prospects that if they liked a plan I presented and the way I treated them to please enroll through me directly when they are ready. Since some folks don’t realize that fact and after I spend my time and knowledge with them they could inadvertently sign up online or through the US Mail with that same exact insurance carrier. Then I wouldn’t get paid at all. So as a courtesy and to be fair, I ask clients if they like a plan I presented and they way I treated them, to please enroll through me directly.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

As I mentioned above, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare Insurance Plans - Renew Or Should You Replace?


Again there seems to be a lot of Medicare Advantage Plan changes for this upcoming year. If you are 65 or older and are already enrolled in a Medicare Advantage plan, you should have received a letter from your insurance carrier explaining the changes specific to your policy.

I can review your existing Medicare insurance plan with you to help determine if you feel your existing plan still best fits your needs for the upcoming year. I can also assist by explaining some different Medicare Insurance plan options that you can compare and switch to, if you so desire. I’ll try to simplify your options by helping you understand them better.
By the way, it doesn’t cost you any more if you enroll through me as an independent agent versus directly with an insurance company either over the phone or via the Internet.

If any of the topics below apply to you, please call me at 941-404-5334.
By calling this number, I understand I will be directed to a licensed insurance sales agent.  

  • Not happy with your current Medicare Insurance Plan or it costs too much? 

  • Confused about all the changes for this upcoming year?

  • New to Medicare altogether?

  • Know somebody else locally, that will be turning 65 soon, or has an existing plan that they may need assistance with their choices? If so, please have them contact me directly at 941-404-5334.


I am a Licensed Sales Agent that resides locally right here in the Sarasota/Manatee area. Being that I am an independent agent, I am uniquely positioned to help you review the many choices available to you from different insurance companies and assist you in making a choice that will be the most appropriate for your specific needs.

I’ll be happy to set up an appointment with you to explain the different plans I offer, answer your questions, and enroll you in the plan that you feel is best suited to your needs. I’m available to come to your home, office, or another location, whichever is most convenient for you.

So don’t be stuck in a Medicare Insurance plan you don’t like or costs too much, since you are permitted to change Medicare Insurance Plans during this Annual Enrollment Period starting October 15 and ending December 7.

Please call me at 941-404-5334 to set up your appointment today to help simplify your choices!
B
y calling this number, I understand I will be directed to a licensed insurance sales agent.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Limits on Balance Billing and Private Contracting by Physicians


Good informative AARP fact sheet by Harriet Komisar (dated: January 2017)


AARP fact sheet explains Balance Billing as:

“Balance billing” refers to the practice of charging patients for the difference between a health care provider’s fee for medical services and their health insurance’s allowed fee amount. When balance billing is allowed, the patient is financially responsible for the balance bill, plus any cost sharing such as deductibles and co-insurance required by the insurance plan. Medicare’s current rules limiting balance billing provide important financial protection for consumers.1 


To download the entire PDF Fact sheet article, click on the web link below:

Medicare’s Financial Protections for Consumers: Limits on Balance Billing and Private Contracting by Physicians 

http://www.aarp.org/content/dam/aarp/ppi/2017-01/medicare-limits-on-balance-billing-and-private-contracting-ppi.pdf?CMP=EMC-SNG-ADV-MED-012617&cmp=NLC-ADVOCATE-0117&autologin=true

1. Source: January 2017 AARP Fact Sheet Medicare’s Financial Protections for Consumers: Limits on Balance Billing and Private Contracting by Physicians located at http://www.aarp.org/content/dam/aarp/ppi/2017-01/medicare-limits-on-balance-billing-and-private-contracting-ppi.pdf?CMP=EMC-SNG-ADV-MED-012617&cmp=NLC-ADVOCATE-0117&autologin=true


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part A & Part B - Do I Have To Sign Up Or Does That Happen Automatically?


It all depends on your particular situation.

Some people get Part A & Part B automatically

You may qualify for Medicare Part A (Hospital Insurance) and Medicare Part B (Medical Insurance) if one of the following applies to you:

  • I'm already getting benefits from Social Security or the Railroad Retirement Board (RRB).
  • I'm under 65 and have a disability.
  • I have ALS (Amyotrophic Lateral Sclerosis, also called Lou Gehrig's disease).
  • I live in Puerto Rico and get benefits from Social Security or the RRB.


If you get Medicare automatically

If you're automatically enrolled, you'll get your red, white, and blue Medicare card in the mail 3 months before your 65th birthday or your 25th month of disability.


Some people need to sign up for Part A & Part B 

You need to sign up for Part A and Part B if:

  •     You aren't getting Social Security or RRB benefits (for example, because you're still working).
  •     You qualify for Medicare because you have End-Stage Renal Disease (ESRD).
  •     You live in Puerto Rico and want to sign up for Part B (you automatically get Part A).You must already have Part A to apply for Part B.


To read more click on the web link below:

https://www.medicare.gov/sign-up-change-plans/get-parts-a-and-b/when-how-to-sign-up-for-part-a-and-part-b.html


Related Blog Post:

Medicare Part B Initial Enrollment Information


Note: Keep in mind if you don’t enroll in Medicare Parts A, B or D before the time limit of when you are first eligible for each Part, you may have to pay late penalties depending on your individual situation. If you are not sure of when you have to enroll by to avoid penalties, call the Social Security office to find out in advance!


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part A - The Benefit Periods and Deductibles


Did you know that Medicare Part A deductibles are different than most health insurance deductibles? Rather only being charge once a year like most health or other insurance deductibles, Part A deductibles are charged for each benefit period rather than for the entire year. 


What is a Part A benefit period?

A benefit period is the way the Original Medicare Part A measures your use of inpatient hospital and skilled nursing facility services. It begins the day that you enter a hospital or skilled nursing facility and ends when you have not received inpatient hospital or Medicare covered skilled care in a skilled nursing facility for 60 days in a row. The benefit period is not tied to the calendar year.

You must meet your Part A deductible at the beginning of each benefit period as well as pay a daily coinsurance depending on how many days you stay at the hospital or skilled nursing facility during one benefit period.

If you go into the hospital or skilled nursing facility after one benefit period has ended (more than 60 days after you left), then a new benefit period begins and you are responsible to pay for a new deductible. There is no limit to the number of benefit periods you can have, or how long a benefit period can be.

Example: One benefit period could actually span more than one hospitalization. Imagine you are in the hospital for a short stay and then you’re released. Then a few days later you you need to go back into the hospital. Your benefit period would still in effect. In this particular situation, you would be charged just one deductible.


Lifetime Reserve Days

In Original Medicare, these are additional days that Medicare will pay for when you're in a hospital for more than 90 days. You have a total of 60 reserve days that can be used during your lifetime. For each lifetime reserve day, Medicare pays all covered costs except for a daily coinsurance.1


Medicare Advantage plans set their own cost sharing terms.  

So if you are on a Medicare Advantage plan, your plan may or may not charge deductibles for hospital stays depending on your specific plan. Some plans may charge a flat amount per hospitalization up to a set number of days. Other plans may charge a copay or coinsurance amount for each day in the hospital. Call the member services phone number on the back of your plan member ID card to find out details specific to your plan.


Some additional web links for more info:

Medicare.gov Glossary of Terms

What Is a Medicare Hospital Benefit Period? (AARP)



1. Source: Medicare.gov

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part B - Can I Pay My Premiums Monthly Instead Of Quarterly?


Generally if you collect Social Security benefits, your Part B premiums are automatically deducted from your monthly Social Security checks. Otherwise, if you do not collect a Social Security check (for example you are still working or you decided to delay them) Medicare will bill you directly for quarterly payments. However you can call Medicare at 800-633-4227 and ask to pay monthly. You can pay by check, credit card, or transfers from a bank account.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part B Initial Enrollment Information


Your Initial Enrollment Period begins 3 months before your 65th birthday and ends 3 months after your 65th birthday. If you or your spouse are still working and you receive health insurance from either you or your spouse’s current employer, the insurance is primary if there are 20 or more employees at the company where you or your spouse work.


Should I enroll in Part B at age 65?

  • Some people do not take Part B during their Initial Enrollment Period (IEP) because either they or their spouse are still working and they have primary insurance from a current employer. Talking to your employer is important when you become eligible for Medicare to see how your employer insurance will work with Medicare.


  • If you are already collecting Social Security you will be automatically enrolled in both Medicare Part A and Part B. If you are thinking about turning down Part B, you should call the Social Security Administration at 800-772-1213 and ask if you can do so without any penalties. When you call Social Security, it is important to write down whom you spoke to, when you spoke to them and what they said.



Related Blog Post:

Medicare Part A & Part B - Do I Have To Sign Up Or Does That Happen Automatically?


Note: Keep in mind if you don’t enroll in Medicare Parts A, B or D before the time limit of when you are first eligible for each Part, you may have to pay late penalties depending on your individual situation. If you are not sure of when you have to enroll by to avoid penalties, call the Social Security office to find out in advance!


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part B Premium Announced For 2020



Some key bullet points:

  •     The standard monthly premium will be $144.60 for 2020, which is $9.10 more than the $135.50 in 2019.

  •     The annual deductible for Part B will rise to $198, up $13 from $185 this 2019 year.

  •     About 7% of beneficiaries will pay extra from income-related adjustment amounts.


Medicare Part B Premiums/Deductibles

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment, and certain other medical and health services not covered by Medicare Part A.1 

Each year the Medicare premiums, deductibles, and copayment rates are adjusted according to the Social Security Act.1

The increase in the Part B premiums and deductible is largely due to rising spending on physician-administered drugs. These higher costs have a ripple effect and result in higher Part B premiums and deductible.1 


To read more on this subject, click on the web link below:

https://www.cms.gov/newsroom/fact-sheets/2020-medicare-parts-b-premiums-and-deductibles


1. Source: CMS.gov 
https://www.cms.gov/newsroom/fact-sheets/2020-medicare-parts-b-premiums-and-deductibles


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - Closing the Coverage Gap


The Medicare Part D Coverage Gap (also known as the Donut Hole) closed in 2020. Plan members of a Part D or (a Medicare Advantage Plan that includes drug coverage) will only pay 25% coinsurance of Brand-name and Generic drugs while in the coverage gap. 

The coverage gap closed by keeping the manufacturers 50% discount and increasing what Medicare drug plans cover. The coverage gap had been gradually shrinking for several years since the Affordable Care Act set a path to close it by 2020. However the gap really was never scheduled to close 100%. This still doesn’t mean you will get your medications for free, plan members will still pay 25% out of their pockets while in the coverage gap stage. However if your total prescription drug costs exceeds a certain dollar amount (which the amount can and usually does change each year), then your total out of pocket prescription drugs costs goes back down to a specified level during what is called the “Catastrophic" coverage stage.


Click on link for a related blog post of what is the coverage Gap (also known as the Donut Hole): Medicare Part D - The Doughnut Hole



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - Closing The Donut Hole!


I read a Medicare Rights Center Blog post as well as other articles from different sources. So I thought I’d share this relevant information I found about closing the "Donut Hole!” 
Note: For those of you that may be unfamiliar with the term “Donut Hole,” it is also known as a “Coverage Gap" for Part D prescription drug plans.

So you may be thinking what does that mean to me. In 2020, the donut hole has closed. Even with the Donut Hole closing, that still does not mean you won’t have to pay for medications once they get to this drug payment stage.

Here is a little background:
When Part D first started in 2006, the Part D drug plan had a gap in coverage. Drug plans did not pay anything toward the cost of drugs in the donut hole so beneficiaries were stuck with the tab for the entire cost. 

"When Congress expanded Medicare to cover prescription drugs by adding Part D, they built in a coverage gap that made drug coverage disappear when people reached a certain spending level, then reappear when they hit another threshold. This donut hole left many people with Medicare struggling to afford their medications for at least part of the year.”1

However in 2012, the Affordable Care Act made changes and implemented discounts for the Donut Hole which reduced the impact to Part D plan members. Each year, those discounts slowly reduced the out of pocket percentages that members were required to pay during the Donut Hole. After 2020, drug plan members will no longer face an increased percentage of the cost for medications during the Donut Hole. They will pay 25% of the cost for any prescribed medication from the time they meet the deductible until reaching the out-of-pocket spending limit. 


Click on web link below to read the entire Medicare Rights Center Blog post:

https://blog.medicarerights.org/closing-donut-hole-means-matters/


1. Source: Medicare Rights Center Blog
https://blog.medicarerights.org/closing-donut-hole-means-matters/

2. Source: 65 Incorporated 
https://www.65incorporated.com/topics/medicare-part-d-prescription-drug-plans/medicare-donut-hole-closing/

3. Additional Source: KFF
https://www.kff.org/medicare/issue-brief/closing-the-medicare-part-d-coverage-gap-trends-recent-changes-and-whats-ahead/

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - Donut Hole Costs 2020


Many members of Prescription Drug Plans (or Medicare Advantage Plans with Prescription Drug coverage included) may wonder why they still have a copayment during the donut hole for their prescription drugs in 2020.

Almost 20 years ago, Medicare beneficiaries were responsible for 100% of their drug costs during the coverage gap until they spent all the way up to the catastrophic level. The coverage gap was also called the “Donut Hole.” The 2010 Affordable Care Act slowly eliminated the Donut Hole a little at time and by 2020 it was fully eliminated. Although the Donut Hole is technically closed, Part D members must still show they contribute 25% of the drug cost share.


For more on this topic, click this web link to read a related blog post.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - Drugs Not Covered!


There are certain types of drugs that are excluded from Medicare coverage by law. 

Medicare does not cover:1 

  • Drugs used to treat anorexia, weight loss, or weight gain.
    • Note: Part D may cover drugs used to treat physical wasting caused by AIDS, cancer, or other diseases
  • Fertility drugs
  • Drugs used for cosmetic purposes or hair growth 
    • Note: Drugs used for the treatment of psoriasis, acne, rosacea, or vitiligo are not considered cosmetic drugs and may be covered under Part D
  • Drugs that are only for the relief of cold or cough symptoms
  • Drugs used to treat erectile dysfunction
  • Prescription vitamins and minerals (except prenatal vitamins and fluoride preparations)
  • Non-prescription drugs (over the counter drugs)


Note: Prescription drugs used for the above conditions may be covered if they are being prescribed to treat other conditions. For example, a medicine for the relief of cold symptoms may be covered by Part D if prescribed to treat something other than a cold—such as shortness of breath from severe asthma—as long as it is approved by the U.S. Food and Drug Administration (FDA) for such treatment.
1

Keep in mind just because Medicare does not exclude your prescription drugs, you still need to make sure that your drugs are in the *formulary for your plan or it will not be covered by your plan, with very few exceptions.

*Formulary is a list of drugs covered by your plan.


1. Source: https://www.medicareinteractive.org/get-answers/medicare-prescription-drug-coverage-part-d/medicare-part-d-coverage/drugs-excluded-from-part-d-coverage



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - Enroll On Time Or Get Penalized!


Three ways to avoid the late enrollment penalty for Part D
(Prescription Drug Plan) 


  1. Join a Medicare Prescription Drug Plan when you are first eligible for Part D.

  2. Do NOT go 63 days or more in a row without a Medicare drug plan or other creditable drug coverage.
    Note: Your existing plan must tell you each year if your drug coverage is creditable coverage. They may send you this information in a letter, in a newsletter, or other piece of correspondence. Keep this information because you may need it if you join a Medicare drug plan later.

  3. Tell your Medicare drug plan about any drug coverage you had if they ask about it.
    Note: When you join a Medicare drug plan, the plan will send you a letter if it believes you went 63 days or more in a row without other creditable drug coverage. The letter will include a form asking about any drug coverage you had. Complete the form and return it to your drug plan by the deadline in the letter. If you don't tell the plan about your creditable drug coverage in a timely fashion, you may have to pay a monthly penalty.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - No Limit On What You Can Spend!


I read a Medicare Rights Center blog post by Mitchell Clark regarding that there isn't a maximum spending limit for Part D prescription drugs for many people! The statistics in the article were surprising to me, and not in a good way.

"According to a new issue brief by the Kaiser Family Foundation (KFF), one million people with Medicare Part D had drug costs above the catastrophic limit in 2015. On average, they spent $1,251 after they hit the catastrophic limit and more than $3,000 total on their prescriptions for the year.

While Part D helps bring down the drug costs for people with Part D, many are still exposed to high drug costs. This is because Part D does not place a cap on how much people can spend out of pocket on their drugs.”1

To read the entire article, click on the web link below:

https://blog.medicarerights.org/many-medicare-part-d-theres-no-limit-can-spend-prescriptions/


1. Source: Medicare Rights Center Blog
https://blog.medicarerights.org/many-medicare-part-d-theres-no-limit-can-spend-prescriptions/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - Pricey Drugs Overwhelm Medicare Safeguard

Source: Associated Press article by Ricardo Alonso-Zaldivar

I read this interesting AP article by Ricardo Alonso-Zaldivar and thought I would share. Click on web link below to read article. 

After reading the entire article, you determine for yourselves whether many of these prescription drug companies are just in it for the maximum profit no matter what and don’t really care about the consequences of the end users.


To read the entire article click on the link below:

https://apnews.com/6a2bd10f24d54fe29f9b66894c163777

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D - The Doughnut Hole


The doughnut hole, (also known as the coverage gap) is a stage of Part D prescription drug coverage during which the amount you pay for your prescription drugs increases. In the past, most people had to pay the full cost of their drugs in the coverage gap. However now due to the Affordable Care Act (ACA), members no longer have to pay the full cost of their drugs during this period.

The doughnut hole starts when the “total" drug costs of the drugs included in the plan (Note: the total is comprised of both what members have paid and also what their insurance plan have paid for their drugs), reaches a specified amount since the start of the calendar year. At that point when you are considered in the doughnut hole, then members start pay a set percentage on most brand-name drugs and a set percentage on generics, the manufacturer plus the federal government are responsible for the rest. (Note: Each year since ACA, the actual percentage owed by the member has been decreasing which is good news for the Part D plan members).

The even better news is that these percentages owed by the members are supposed to gradually decrease each year until 2020. Starting in 2020, members will typically pay no more than 25 percent of the cost of their drugs at any point during the year after they have met their deductible.

Members of their prescription drug plan (or members of their Medicare Advantage Plan, that include prescription drug coverage) get out of the coverage gap stage when they have paid a specific set amount of out-of-pocket expenses for covered drugs since the start of the year. Then at that point they move to the next stage called the catastrophic stage, which is when members start to pay a lot less. (Each year that specific set amount of out of pocket expenses for the catastrophic stage been changing.) The costs that help members get out of the coverage gap include what they spent on drugs, most of the discount on brand-name drugs that they received in the coverage gap, and the cost of drugs that someone else pays on their behalf (such as family members, most charities, or State Pharmaceutical Assistance Programs).


Related Blog Posts:

Medicare Part D and Prescriptions

Medicare Part D Gains May Be Eroding


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Part D and Prescriptions


Each Medicare Prescription Drug Plan has its own list of covered drugs (called a formulary). Many Medicare drug plans place drugs into different "tiers" on their formularies. Drugs in each tier have a different cost.

A drug in a lower tier will generally cost you less than a drug in a higher tier. In some cases, if your drug is on a higher tier and your prescriber thinks you need that drug instead of a similar drug on a lower tier, you or your prescriber can ask your plan for an exception to get a lower co-payment.

A Medicare drug plan can make some changes to its formulary during the year within guidelines set by Medicare. If the change involves a drug you're currently taking, your plan must provide written notice to you at least 60 days prior to the date the change becomes effective.


Related Blog Posts:

Medicare Part D - The Doughnut Hole

Medicare Part D Gains May Be Eroding

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Source: Courtesy of Insurance Associates Group

Medicare Part D Gains May Be Eroding


This New York Times article by Paula Span discusses how Medicare Part D out-of-pocket costs & benefits seem to eroding from when Part D first started in 1996.

From a sample study, it appears people that are more ill and need more medications seem to have the most problems. So it is not surprising that people with multiple health problems are affected the most and people on fixed incomes may struggle to pay their bills.

The article goes on to say that Part D plans have been changing. They appear to be covering fewer medications, and are using more tiering strategies by putting some drugs in very high priced tier levels. In addition, the insured also may be facing more restrictions.

To read the entire article, click on the link below.

http://newoldage.blogs.nytimes.com/2014/08/21/part-d-gains-may-be-eroding/?_php=true&_type=blogs&_r=0


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Payments To Insurance Companies For Medicare Advantage Will Increase



This Herald-Tribune article dated April 8, 2015 by Maggie Clark mentions that there will be increase in payments to insurance companies which offer Medicare Advantage insurance plans.

About 30 percent of all Medicare beneficiaries are enrolled in private Medicare Advantage plans, which receive a lump sum from the government for each enrollee and reimburse providers in its network at rates agreed upon in advance. Insurers profit on any remaining balance after enrollees’ bills are paid.

The 3.25 percent payment increases from Medicare to insurers for 2016 are due to higher than average spending on inpatient hospitalizations, therapy, rural health centers and federally qualified health centers, according to federal regulators at the Centers for Medicare and Medicaid services. 

To read the full article, click on the link below.

http://www.heraldtribune.com/article/20150408/ARTICLE/150409722/2416/NEWS?p=all&tc=pgall&tc=ar


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Premiums Paid Possibly Could Save You Money If You Itemize Your Taxes


I read a MarketWatch article by Bill Bischoff with tax tips that could possibly save you money if you pay Medicare Premiums and you itemize your taxes. Of course, always check with your accountant first!

Before you get too excited please keep in mind that because the Tax Cuts and Jobs Act greatly increased the standard deduction amounts for 2018-2025, fewer individuals will be itemizing. However having significant medical expenses (including those for Medicare health insurance premiums) may allow you to itemize and collect some tax savings. 

Click on web link below to read the entire article:

https://www.marketwatch.com/story/how-medicare-premiums-could-be-the-key-to-itemizing-your-taxes-and-saving-money-2019-01-02


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Questions - Plans, Parts, & More


Confused about Medicare? Well, you aren’t alone! There is an alphabet soup of letters designating parts of Medicare, Medicare Supplement Insurance Plans, etc.

I'll start with the basics.
What are the individual parts of Medicare? Listed below are Parts A, B, C and D with brief descriptions and links to Medicare.gov for more info.

Part A: Hospital Insurance
(Includes skilled nursing facilities or hospice, and some home health care.)

For more details on Part A, click on this link


Part B: Medical Insurance
(Includes doctor services, outpatient care, durable medical equipment and some preventive services.) 

For more details on Part B, click on this link


Part C: Medicare Advantage

Medicare Advantage plans are offered by private insurance companies as an alternative to Original Medicare; plans are government subsidized and regulated. A Medicare Advantage Plan (like an HMO or PPO) is another Medicare health plan choice you may have as part of Medicare. 

If you join a Medicare Advantage Plan, the plan will provide all of your Part A (Hospital Insurance) and Part B (Medical Insurance) coverage. Medicare Advantage Plans may offer extra coverage, such as vision, hearing, dental, and/or health and wellness programs. Most include Medicare prescription drug coverage (Part D).

For more details on Medicare Advantage plan, click on this link

To learn more about costs for Medicare Advantage Plans, click on this link


Part D: Prescription Drug Coverage

Part D Plans are offered by private companies to provide coverage for prescription drug costs; plans are government subsidized and regulated.

For more details on Part D, click on this link

======================================================================


Medicare Supplement Plans

A Medicare supplement (Medigap) insurance policy, sold by private companies, can help pay some of the health care costs that Original Medicare doesn't cover, like copayments, coinsurance, and deductibles.

Some Medigap policies also offer coverage for services that Original Medicare doesn't cover, like medical care when you travel outside the U.S. If you have Original Medicare and you buy a Medigap policy, Medicare will pay its share of the Medicare-approved amount for covered health care costs. Then your Medigap policy pays its share.

A Medigap policy is different from a Medicare Advantage Plan. Those plans are ways to get Medicare benefits, while a Medigap policy only supplements your Original Medicare benefits.

For more details on Medicare Supplements (Medigap) click here.

Source: Medicare.gov

======================================================================


Medicare Costs

Medicare Costs At A Glance, click this link.


======================================================================

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Rating Updates For Local Sarasota/Manatee Area Hospitals


I read this informative Sarasota Herald-Tribune article dated December 21, 2017 regarding local hospitals in the Sarasota/Manatee area that recently received updated Medicare ratings and thought I’d share it.


Excerpts:

  • In quarterly federal rankings updated this week, Doctors Hospital of Sarasota joins Sarasota Memorial Hospital as the two five-star facilities in Southwest Florida’s three-county region.1

  • Lakewood Ranch Medical Center retains three stars. Venice Regional Bayfront Health fell from three stars to two; Fawcett Memorial Hospital fell from three stars to one; and Manatee Memorial Hospital, Blake Medical Center and Bayfront Health Port Charlotte fell from two stars to one.1


To read the entire article click on the web link below:

http://www.heraldtribune.com/news/20171221/medicare-updates-ratings-for-local-hospitals



1. Source: Sarasota Herald-Tribune http://www.heraldtribune.com/news/20171221/medicare-updates-ratings-for-local-hospitals



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Spills Beans On Hospital Billing


A Wall Street Journal article by Matthew Heimer sheds some light on just how disconnected the costs of care of hospital bills can be from one hospital to another for the exact same procedure and how much those amounts can differ from what Medicare allows for reimbursement! Also the lack of transparency in medical prices makes it difficult for consumers to make informed decisions about their treatment and at what facility location they should have their procedure preformed.

I personally recently tried to get an estimate on a non-Medicare medical procedure in advance and it was very difficult as well as very time consuming. When I finally got a "so called" estimate, they told me that  they couldn't be held responsible for the accuracy of the estimate. Go figure! In my opinion, not many other industries could get away with such vague price estimates and/or high prices for things that are generally important and difficult to do without. 

Another similar type article in the the local Sarasota Herald-Tribune by Donna Koehn, but this article entitled "Charges vary widely between local hospitals, new data show" is more relevant to the local Sarasota, FL area. Here is one exerpt from the article, "CMS spokesman Brian Cook said what hospitals ask is typically about five or six times what Medicare pays." .

Original Web Links to articles are no longer accessible but I listed the sources below anyway: 

Sources:

"Medicare spills beans on hospital billing” http://blogs.marketwatch.com/encore/2013/05/08/medicare-spills-beans-on-hospital-billing/

"Charges vary widely between local hospitals, new data show” http://www.heraldtribune.com/article/20130508/ARTICLE/130509665/2416/NEWS?p=all&tc=pgall


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Still Strong And Built To Last!


Fact Sheet dated January 2017: 

Medicare Rights Center came out with some interesting facts regarding Medicare.

  • 57 million Americans rely on Medicare for health insurance coverage.1
  • More than 95% of Americans consider Medicare an important program.1
  • Around 90% of Americans want federal Medicare spending to stay the same or increase.1
  • Around 85% of Americans want Medicare to negotiate drug prices.1
  • People with Medicare already pay a significant amount toward health care. In 2012, they paid 14% of household expenses toward health care costs, nearly three times as much as those not yet on Medicare.1
  • Medicare does a better job of controlling costs than private health plans.1
  • Baby Boomers need Medicare to retire.1
  • Past proposals to implement premium support would give people with Medicare a voucher or coupon to purchase health coverage, either a private plan or Original Medicare. The value of the voucher is not likely to keep pace with rising health care costs, meaning people with Medicare would pay significantly more.1 
  • Medicare provides health coverage less expensively than private insurance and has lower administrative expenses than private health plans which, by design, turn a profit.1
  • Medicare is not going bankrupt.1



1.Source: http://blog.medicarerights.org/medicare-strong-built-last/ January 2017
http://blog.medicarerights.org/medicare-strong-built-last/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Summary Notice - What Is It?



“ 'Medicare Summary Notice' (MSN)

What is it?

It's not a bill. It’s a notice that people with Original Medicare get in the mail every 3 months for their Medicare Part A and Part B-covered services.

The MSN shows:

  • All your services or supplies that providers and suppliers billed to Medicare during the 3-month period
  • What Medicare paid
  • The maximum amount you may owe the provider


When should I get it?

You’ll get your MSN every 3 months if you get any services or medical supplies during that 3-month period.  If you don’t get any services or medical supplies during that 3-month period you won’t get an MSN for that particular 3-month period.

Note: Did you know you can get your MSNs electronically (eMSNs)? If you choose eMSNs, you’ll get a monthly email instead of having to wait 3 months for a paper copy in the mail.
Find out how to get eMSNs.

If I need to change my address:

Contact Social Security.

If you get RRB benefits, contact the RRB.

Who sends it?

Medicare 

If you're not sure if your MSN is from Medicare, look for these things on the MSN envelope [PDF, 380 KB].

What should I do if I get this notice?

  • If you have other insurance, check to see if it covers anything that Medicare didn’t.
  • Keep your receipts and bills, and compare them to your MSN to be sure you got all the services, supplies, or equipment listed.
  • If you paid a bill before you got your notice, compare your MSN with the bill to make sure you paid the right amount for your services.
  • If an item or service is denied, call your doctor’s or other health care provider's office to make sure they submitted the correct information. If not, the office may resubmit. If you disagree with any decision made, you can file an appeal. On the new MSN design, the last page of the MSN gives you step-by-step directions on when and how to file an appeal.”1


To read more, click on the web links below:


1. Source: Medicare.gov


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Supplement - Are You Allowed To Enroll During Any Month?


Medicare Supplement Plans (also known as Medigap plans) have different enrollment rules than Medicare Advantage Plans or Medicare Prescription Drug Plans.

So the answer depends on several factors and also can vary from state to state. 

Keep in mind if you don’t qualify for Guaranteed Issue or it is not during your Medical Supplement Open Enrollment Period, you will need to go through the Medicare Supplement insurance company’s medical underwriting and meet their guideline requirements in order to be approved. (Meaning, depending on the Insurance company, if you can truthfully answer “NO" to all their eligibility questions on the application, you should be approved. If you answer “YES" to any of the questions, most of the time you will be declined!)

Below are some examples in Florida of when you can enroll in a Medicare Supplement during any month you choose:

  • You are coming off an employer health insurance group plan and you are leaving either involuntarily or voluntarily (both are allowed), and you have had continuous credible health insurance coverage since you were first eligible for Medicare. (Credible coverage means that you had coverage at least equal to or better than Medicare coverage.) It is best to speak with your employer administrator first. Once you leave your employer health insurance, generally you cannot return to your employer health insurance.

  • You can enroll any month during your Medicare Supplement Open Enrollment Period.
    Pasted from Medicare.gov "The best time to buy a Medigap policy is during your 6-month Medigap Open Enrollment Period. You generally will get better prices and more choices among policies. During that time you can buy any Medigap policy sold in your state, even if you have health problems. This period automatically starts the month you're 65 and enrolled in Medicare Part B (Medical Insurance), and it can't be changed or repeated.”1 

  • Click on the web link below for more info:
    https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap


Example of when you can not switch to a Medicare Supplement on any given month, but need to wait until the Annual Election Period, unless you qualify for a Special Election Period:

  • Even though the Medicare Supplement Insurance company may allow you to enroll in Medicare Supplement any month of the year, if you already have a Medicare Advantage plan you won’t be able to terminate that Medicare Advantage plan until the Annual Election Period unless you qualify for a Special Election Period. You can NOT have both a Medicare Supplement and a Medicare Advantage plan at the same time. Also keep in mind, if you are planning on switching Prescription Drug Plans, you won’t be able to switch that type plan either until the Annual Election Period, unless you qualify for a Special Election Period.

  • Click on the web link below for more information on Special Election Periods
    https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances-special-enrollment-periods



Source: 1. https://www.medicare.gov/supplements-other-insurance/when-can-i-buy-medigap


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Supplement - If I Cancel, Can I Get It Back?


I read an interesting and informative AARP article regarding Medicare Supplement Plans (Also known as Medigap Plans) and thought I’d share it. There are many different circumstances and one answer doesn’t fit everybody. So the answer on whether you can get a Medicare Supplement plan back after you cancel it, well that will depend on your individual circumstances.


Some of the main points you may want to know are:1

  • Medicare Supplement Plans (Medigap Plans) are not government programs, but are through private insurance companies.
  • Medicare Supplement Plans (Medigap Plans) can be bought, or changed at any time of the year. (However it is only at special times that you can buy a policy with federal protections known as “guaranteed issue.”) Also unless you qualify for a special election period, there are only certain times of the year when you can also add, change, or cancel a stand alone Prescription Drug Plan, that many people have in addition to their Medicare Supplement Plan at the same time. Those Prescription Drug Plans provide drug coverage that compliments their Medicare Supplement Plans. (Note: There are a few states that may allow you to get a Medicare Supplement plan with guaranteed issue any time during the year, so be sure to check you specific state rules.)
  • If you don’t qualify for guaranteed issue for your Medicare Supplement plan, then you have to answer the Medicare Insurance underwriting questions (which can vary from company to company), and depending on your answers, you may be approved or you may be denied coverage for getting back into a Medicare Supplement plan.
  • The most common time for buying Medicare Supplement with guaranteed issue is within six months of their Medicare Part B coverage going into effect.
  • The article lists other circumstances in which you can buy a Medicare Supplement with guaranteed issue.


To read the entire article click on the web link below:

https://www.aarp.org/health/medicare-qa-tool/cancel-medigap-can-i-reenroll-at-open-enrollment/


1. Source: AARP Web Site - https://www.aarp.org/health/medicare-qa-tool/cancel-medigap-can-i-reenroll-at-open-enrollment/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Supplement Changes for Plans F & Plan C - Starting 1-1-2020


I am trying get way ahead of any stress you might incur later on in the year regarding hearing about changes to your Medicare Supplement Plan F (or Plan C). So as a courtesy to avoid any misinformation that might be floating out there I thought I would write this blog post to explain in advance. That way you will know correct answers well in advance to alleviate any possible concerns about changes you may hear later on in the year regarding your existing Medicare Supplement insurance.

If you are already have an existing Medicare Supplement Plan F or Plan C, don’t worry you will be able to keep your existing plan, since you will be grandfathered in! 

Plans C, F, and High Deductible F will still be available for beneficiaries who were Medicare eligible prior to 12/31/19.

The new rule only effects newly eligibly people that want to enroll in a Medicare Supplement and are only eligible AFTER 1/1/2020!


What is MACRA?

MACRA stands for the Medicare Access and CHIP Reauthorization Act of 2015. The new rule states that as of January 1, 2020, newly-eligible Medicare beneficiaries won’t be able to purchase Medicare supplement plans that cover the Part B deductible. This includes Medicare supplement Plans C, F, High-Deductible F (and Minnesota and Wisconsin Part B deductible coverage). 

Medicare-eligibility through December 31, 2019

For those of you who are already Medicare-eligible or will be through December 31, 2019, your Medicare options are the same as they have always been. You can keep your existing plan or purchase any that cover the Part B deductible.

Medicare-eligibility January 1, 2020 and after

The MACRA rule will impact people who become Medicare-eligible after December 31, 2019 as the are considered “newly-eligible” and won’t be able to purchase plans that cover the Part B deductible. Their plan choices include some type of cost-share. Additionally, MACRA makes Plans D and G the guaranteed issue plans for newly-eligible Medicare beneficiaries (as of January 1, 2020) for the specified period under current law that name Plans C or F for current beneficiaries.

If you are either current Medicare supplement policyholders or are Medicare eligible prior to January 1, 2020 be assured that your Medicare supplement options are unchanged and no action is required!

 





——----------------------------------------------------------------------------------------------------------------

Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare Supplement Price Shopping When You Already Have An Existing Medicare Supplement


Depending on certain factors, many people that bought their Medicare Supplements years ago are grandfathered into their Medicare Supplement plan premiums at “issue age.” (Meaning the age when you got approved on your current Medicare Supplement Plan.) In those cases, the only annual increases you may have had, should have been just inflationary increases across the board. Those type of annual increase were not age related, nor related to health issues that occurred after the start of your plan. However, if you switch to a different insurance company or later come back to the same company after leaving, your premium will now be priced at your current age. Therefore you most likely already have the lowest premiums. Although in certain situations, it is still possible to try to lower your premiums. So if you would like me to shop your current Medicare Supplement premium to compare with another insurance company to determine if you can possibly get a lower premium with the same coverage, please call me with the following information: 

  • Your current monthly premium of just your Medicare Supplement (NOT including your Prescription Drug Plan premium)
  • Your zip code
  • Your birth date including year
  • The Plan Letter of your current Medicare Supplement Plan (Example: Plan F)
  • Whether or not you are a tobacco user.

 

Note: Before shopping rates, keep in mind when switching Medicare Supplement plans after 65 (unless you qualify for guaranteed issue for another reason), now going forward you will need to be able to pass underwriting to be approved for a new policy. There are a series of questions the insurance companies ask on the application. Unfortunately if you answer “yes” to any of those questions, you will be declined. I am pasting below a sample of the questions from one insurance company to help determine if you would be able to be approved before comparing prices. Most underwriting questions from Medicare Supplement Insurance companies are similar, but each company may ask different or additional questions. Attached is just a sample of the underwriting questions from one company.

If you have questions, please feel free to call me.



To Read More Click On Related Blog Post Link Below:

Medicare Supplement Shopping & Comparison


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare Supplement Shopping & Comparison


When shopping and comparing Medicare Supplement (Medigap) plans there are many things to understand before making a decision on which insurance company and plan to purchase.1 


Some of the things you should understand before you purchase are:

  • You must have Medicare Part A and Part B first before getting enrolled in a Medicare Supplement Insurance Plan. You should contact the Social Security Office to inquire about enrolling in both Part A and Part B several months in advance of your 65th Birthday (or several months before you become eligible Medicare Part B, for example if you plan on working past your 65th Birthday, etc.)

  • You should understand that the Plan Letters for Medicare Supplement Plans are “standardized" by the Federal Government. Which means if you are shopping, for example for a Medicare Supplement "Plan F,” then all the Medicare Supplement Insurance companies are required to offer the same exact Standardized “Plan F” plans, however they are allowed to charge different premiums. So basically you want to shop for the lowest premium of the specific plan you choose, since the only real difference will be the premium prices of the same exact plan from one Medicare Supplement insurance Company to another, with the following exceptions:
    • You should make sure the Insurance company is reputable and pays their claims on time. (Otherwise just a low premium price doesn’t really matter, if the Medicare Supplement insurance company isn't paying your claims on time.) It is also a good idea to check the insurance company’s financial rating, since you want to make sure they will be around in the future for paying your claims.
    • You should check on the previous history of annual rate increases. Although the previous history doesn’t guarantee future rate increase percentages, it may give you a better idea of their track record from the past. Some Medicare Supplement plans can increase quite a bit more annually than the same exact plan from another insurance company. Keep in mind that if your premiums go up, you don’t automatically qualify for another Medicare supplement with a different insurance company in your later years, since there are underwriting questions asked, which depending on your health you may or may not qualify to be approved. So you may be stuck with your original Medicare Supplement's higher premium rates or be forced to choose to switch to a different type plan. (Such as: Medicare Advantage or keep plain Original Medicare without a Medicare supplement.)
    • Some Insurance companies may offer additional (value-added) services on top of the basic benefits. (Value-added services vary by state and generally can be discontinued at any time!)
    • Many Insurance companies may have different underwriting criteria. Meaning if you do not qualify for either "Open Enrollment” or “Guaranteed Issue,” you could possibly get declined with one insurance company but still get approved with another insurance company since each insurance company may have specific underwriting guidelines you need to fit into in order to be approved. 
    • One insurance company allows you to switch plan letters anytime during the year within the same company. You can call and just request to be switched to a different plan letter and it will be effective the 1st of the next month! Check to if the insurance company you choose offers this benefit. Since that could turn out to be a real advantage if find you are ill mid-year with lots of out of pocket expenses.

  • You are not allowed to have both a Medicare Advantage Plan and a Medicare Supplement plan at the same time!

  • There are many Medicare Supplement plan letters to choose from. See chart below. Make sure you understand the benefits and the monthly premium amount of the specific plan letter you choose before enrolling. 

  • The private insurance company's Medicare Supplement premium is in addition to your monthly Part B premium you pay to Medicare. (and also in addition any premium you may pay for Part A as well, if applicable. Most people don’t pay a premium for Part A. However there are some that do.)

  • Any standardized Medicare Supplement plan is guaranteed renewable even if you have health problems as long as you stay with the same company continuously. The means the insurance company can not cancel your Medicare Supplement as long as you pay your premiums.

  • Newer Medicare Supplements (Sold after Jan. 1, 2006) aren’t allowed to cover prescription drug coverage. However you can enroll in an additional Prescription Drug Plan (Part D plan) if you want prescription drug coverage. 


If I can assist you with your Medicare Supplement enrollment questions, please call me at
941-404-5334 to make an appointment. I will come to you! (if relatively local.)


1. Note: The information below applies to Florida. (Some other states may have similar information or different regulations. However since I am licensed in the state of Florida, my information pertains to Florida. You will need to check your own states' regulations if you permanently reside in another state, since other states may have different regulations. For example: In Massachusetts, Minnesota and Wisconsin, the Medicare Supplement policies are standardized in a different way.)


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


_____________________________________________

See chart below of different Medicare Supplement (Medigap) plans side by side:1

Note: Not all Medicare Supplement (Medigap) plans are offered in every state by every Medicare Insurance Company.

1. Source: Medicare.gov as of 4-26-17

Medicare Supplements - Attained Age vs. Issue Age


What is the difference between attained age and issue age in regards to Medicare Supplements? Before I get into that topic, I want to give you some other basic information first.

  • Medicare Supplements are also known as Medigap Policies. (The terms can be used interchangeably.)
  • All Medicare Supplements policies will have increases in rates over time.
  • There are two types of rate increases:

1. Medicare Supplement Rate Increases That Are Due to Age
As we get older, our health can and usually does deteriorate. In regards to Medicare Supplements, the insurance carrier may raise the rate a little bit each year upon your birthday due the increased likelihood of higher claim amounts as we age.  Generally this is just a couple of percentage points, but can vary depending on your specific policy.  You will find this type of rate increase in the attained age Medicare Supplements policies, which are the most common type of Medicare Supplement policies.

2. Medicare Supplement Rate Increases That Are Due to Inflation
The cost of medical care in the United States keeps increasing. As the cost of health goes up, the cost of your Medicare Supplement claims will also increase. Insurance companies will have statewide rate increases nearly every year on every kind of Medicare Supplement policy to keep up with the increasing cost of claims. The insurance carrier must first file its proposed rate increase with the state Department of Insurance for approval. Then they’ll notify you by mail of the effective date of the increase.


Note: You should also understand that Original Medicare itself usually increases the amount of your Part A and Part B deductibles ever year. Medicare Supplement policies often cover these deductibles for you, depending on which plan you chose to enroll in. So if your Medicare Supplement plan is covering a higher deductible for you the next year versus what it did this current year, then your Medicare Supplement rates must also increase over time.


Issue Age Medicare Supplement Policies
An Issue Age rated Medicare Supplement policy means that you buy your policy based on your age at the time of application. Example: Somebody who is 75 will pay a higher premium when they purchase, then say their neighbor who is 65. However, once the policy is issued, it will never increase specifically based on your age. (Unless you terminate your policy, then later decide to reapply down the road. In that case, when you reapply, premiums will be based on your current age at the time of application.) Note: The premiums can still increase due to inflation and rising costs of healthcare, but just not due specifically to your age


Attained Age Medicare Supplement Policies
Attained age policies increase in price as you get older. Generally the insurance company has only a small increase for your attained age though. Most of the time these policies are expensive when you purchase them compared to what an issue age policy might cost you. They are certainly worth comparing so that you get the policy that you feel offers the best financial outlook.


Each state has different regulations.
Note: Florida has only allows issue age Medicare Supplement policies.





Medicare Supplements - Pros and Cons


No one type of Medicare Insurance plan fits everybody the same. What may work best for one person, may not work very good for another person. It is a personal choice for you to decide, but it is important to get all the facts first before making a decision. However it is also important to pick the correct plan that fits your needs. Not all Medicare Supplement plans (also known as Medigap plans) have the same benefits. Different Medicare Supplement Plan Letters have unique benefits to each "Plan Letter." However the Medicare Supplement Plan Letters are standardized by plan letter and regulated by the government. For example, a Plan G with one insurance company will need to be exactly the same as a Plan G with another insurance company. The only real difference will be premium rates, how quickly they pay their claims, customer service, how much the premiums may increase annually, and also any possible value added services such as fitness club memberships, etc. they may offer.


Pros:

  1. Medicare Supplement Plans are more flexible than Medicare Advantage plans in that the Medicare Supplement Plans do not have a network of providers. You may go to any doctor or hospital in the U.S. that accepts Medicare. Very handy when somebody travels a lot OR just wants the flexibility to go to any doctor in the U.S. that accepts Medicare.

  2. Medicare Supplement insurance plans work with Original Medicare, Part A and Part B, and may help pay for certain costs that Original Medicare doesn’t cover. For Medicare covered items and services, a Medicare Supplement plan may “supplement” what Original Medicare doesn’t pay.

  3. Depending on what Medicare Supplement Plan Letter you choose, many plan letters may not have any copays or coinsurance each time you visit a doctor or go to a hospital. (So less unexpected out of pocket expenses vs. a Medicare Advantage Plan.) Examples: Plan F doesn’t even have any deductible for those that are eligible for a Plan F!  However if you just turned 65 on or after January 1, 2020 you can no longer choose a Plan F. The Plan G would be the closest plan to a Plan F. The only difference with a Plan G vs Plan F is that you would have a Part B annual deductible. However Plan G premiums are less expensive than the Plan F, so that Part B deductible you would need to pay out of pocket is pretty much offset by lower premiums. Many times a Plan G is less expensive cumulatively for the year, even if after you needed to pay the full Plan B deductible out of pocket as well as pay all your monthly premiums verses a Plan F with just monthly premiums cumulatively for the year.

  4. Unlike a Medicare Advantage Plan, you are not locked into a Medicare Supplement plan for the entire year if you want to switch to another Medicare Supplement company.

  5. Any standardized Medicare Supplement policy is guaranteed renewable even if you have health problems. This means the insurance company can't cancel your Medicare Supplement policy as long as you pay the premium.

  6. Hospitalization: After all lifetime reserve days are used, an additional 365 days (after Original Medicare allows) of Hospitalization are covered with many Medicare Supplement plans.

  7. Some Medicare Supplement Plans include some coverage for Foreign Travel that is NOT covered by Original Medicare. (With a deductible and a maximum lifetime limit)


Cons:

  1. Depending on your budget, the Medicare Supplement Plan monthly premiums can be expensive compared to many Medicare Advantage plans that offer plans with $0 premiums.

  2. Medicare Supplement policies sold after January 1, 2006 aren't allowed to include prescription drug coverage. So if you need prescription drug coverage, you will need to enroll in an additional stand-alone Medicare Prescription Drug Plan adding to the cost of your monthly premiums. (With many Medicare Advantage Plans, prescription drugs are covered within the same plan with no additional monthly premium.)

  3. No Dental care coverage. (With many Medicare Advantage Plans, dental coverage within the same plan is included with no additional monthly premium.)

  4. No Vision coverage for glasses or contacts. (With many Medicare Advantage Plans, vision coverage within the same plan is included with no additional monthly premium.)

  5. No Hearing Aid coverage. (With many Medicare Advantage Plans, hearing aid partial coverage within the same plan is included with no additional monthly premium.)

  6. If you didn’t just recently turn 65 (Medicare Supplement Open Enrollment), or retire from your job while still having employer creditable health insurance coverage (Guaranteed Coverage), you may need to get approved by being able to answer underwriting questions within the company’s approval guidelines. If you can’t answer their underwriting questions within the insurance companies guidelines you will be denied.

  7. (Not really a con, but just an informative note): You must have Medicare Part A and Part B to purchase a Medicare Supplement. You will pay the Medicare Supplement monthly premiums in addition to the monthly Part B premiums that you pay to Medicare. Reminder: If you want prescription drug coverage, you will also have that additional premium as well.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare What Is An Advance Beneficiary Notice? (ABN)


An Advance Beneficiary Notice (ABN), is also known as a waiver of liability. It is an advance written notice of non-coverage that a provider should give you before you receive a service if based on Medicare coverage rules, your provider has reason to believe Medicare will not pay for the service. That way a Fee-For-Service (FFS) beneficiary should be able to make an informed decision in advance about items and/or services that are usually covered by Medicare, but may not be expected to be paid by Medicare in a specific instance for certain reasons, such as lack of medical necessity.

You may receive an ABN if you have Original Medicare, but not if you have a Medicare Advantage Plan. The ABN may look different, depending on the type of provider who gives it to you.

To recap: The ABN allows the beneficiary to make an informed decision in advance about whether to get the item and/or service that may not be covered by Medicare and accept financial responsibility themselves, if Medicare does not pay. If the beneficiary does not get written notice when it is required, he or she may not be held financially liable if Medicare denies payment, and the provider or supplier may be financially liable if Medicare does not pay.1

The Advance Beneficiary Notice must list the reason why the provider believes Medicare will deny payment. Providers are not required to give you an ABN for services or items that are never covered by Medicare, such as hearing aids.


For more information you can download a 13 page PDF document from the CMS.gov website at:

https://www.cms.gov/Outreach-and-Education/.../abn_booklet_icn006266.pdf


1. Source: https://www.cms.gov/Outreach-and-Education/.../abn_booklet_icn006266.pdf


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Medicare, Medigap Cuts May Make You Sick


In this Wall Street Journal article by Elizabeth O'Brien it infers while things are far from being set in stone quite yet, some of the possible proposals for change include beneficiaries with the more comprehensive Medicare Supplement Plans (like Plans C and Plan F) to pay additional taxes. Other proposals could include beneficiaries having to pay more towards out-of-pocket expenses to reduce overall Medicare spending. The theory is if patients have more "skin in the game" in the form of having to contribute more towards their medical expenses, they will be less likely to go to the doctor and have elective surgeries, etc. To read more click link below.

http://www.marketwatch.com/story/medicare-medigap-cuts-may-make-you-sick-2013-05-15


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare: When To Enroll


Informative WSJ article by Andy Landis about when to enroll in Medicare, the pitfalls and penalties of enrolling late, options to enroll if you are still employed and more. 

Did you know you can postpone Medicare until after age 65 if you have health insurance from your current work? Your work health insurance must be based on your own current work or spouse’s current work. It can not be based on COBRA or retiree health insurance. 

If you meet those requirements you can delay Medicare enrollment without penalties for late filing:

  •     You may enroll at any time while covered by the employer's health plan.
  •     You may enroll during the eight-month period starting with the month employment ends, or the month your work insurance ends, whichever comes first.
  •     If you enroll in month one, the month of termination, your Medicare coverage starts the first day of that month
  •     If you enroll after the month of termination, in months two through eight, your Medicare coverage is delayed until the month after you enroll. This could cause a gap in coverage.
  •     You must prove your employer coverage with a letter from your employer.


The original web link to article is no longer accessible, but I listed as the original source below anyway.

Source: http://www.marketwatch.com/story/medicare-when-to-enroll-2013-03-20


Click link below to read more about enrolling in another related blog post:

Medicare – What Do I Need To Do To Enroll?


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Medicare’s Financial Outlook


I read this informative online KFF.org article by Juliette Cubanski and Tricia Neuman regarding 10 Essential Facts About Medicare’s Financial Outlook and thought I’d share it.

The article explains Medicare funding, the Affordable Care Act’s impact on Medicare’s long term financial stability, and what an aging population means for Medicare going forward. It goes on to say that Medicare is likely to be back on the federal policy agenda as Congress debates repealing & replacing the Affordable Care Act, and also if policymakers turn their attention to reducing entitlement spending as part of efforts to reduce the growing federal budget deficit and debt.1


1. Medicare is not “going broke” even though it does face financial challenges.1
When some policymakers talk about Medicare as being “bankrupt” or “going broke” they are referring to the status (or “solvency”) of Medicare’s Hospital Insurance (Part A) trust fund, out of which beneficiaries’ hospital bills are paid. When spending on benefits exceeds revenues (primarily payroll taxes), and assets in the trust fund account are fully depleted, Medicare will not have sufficient funds to pay all Part A benefits. Currently, Medicare’s actuaries estimate that there will be sufficient funds available to pay for hospital insurance benefits in full until 2028. At that point, Medicare will be able to cover 87% of costs covered under Part A through payroll tax revenues - but the Medicare program will not cease to operate.1


2. The aging of the U.S. population, along with higher health care costs, are contributing to the growth in Medicare spending over time.1

Between 2010 and 2050, the population ages 65 and older will double…1

To read entire article for details, please use Web link below towards bottom of article.


3. The Affordable Care Act (ACA) helped to reduce Medicare spending growth in the years following its enactment.1
To read entire article for details, please use Web link below towards bottom of article.


4. Repealing the ACA, including all Medicare provisions, would increase Medicare spending.1

To read entire article for details, please use Web link below towards bottom of article.


5. Medicare spending was 15 percent of the federal budget in 2016.1

To read entire article for details, please use Web link below towards bottom of article.


6. Medicare spending is projected to increase gradually as a share of the federal budget and the nation’s economy over the next 10 years.1

To read entire article for details, please use Web link below towards bottom of article.


7. Medicare spending is projected to increase at a faster rate in the coming years than in the five years following enactment of the ACA.1

To read entire article for details, please use Web link below towards bottom of article.


8. Spending on Part D prescription drug coverage is expected to grow faster than spending on other Medicare-covered benefits over the next 10 years.1

To read entire article for details, please use Web link below towards bottom of article.


9. Medicare spending is projected to increase as a share of the economy over the long run, but the ACA helped to moderate the long-range projections.1

To read entire article for details, please use Web link below towards bottom of article.


10. Medicare benefits are funded mainly by a combination of general revenues, payroll taxes, and premiums paid by beneficiaries.1

To read entire article for details, please use Web link below towards bottom of article.


Click on web link below to read entire article:

http://kff.org/medicare/issue-brief/10-essential-facts-about-medicares-financial-outlook/


1. Source: Kaiser Family Foundation - http://kff.org/medicare/issue-brief/10-essential-facts-about-medicares-financial-outlook/




Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


More Disgruntled Doctors Leave Medicare


It is interesting to find out why some doctors won’t accept Medicare anymore. Since they are not required to accept Medicare, they can just opt out of working with program altogether. This Wall Street Journal article by Matthew Heimer explains a couple reasons why they choose to opt out of accepting Medicare such as: low payment rates and/or they are unhappy with the information sharing they are required under the Affordable Care Act as well as other recent health care reform laws. 

Since more doctors are choosing not to accept Medicare, it is causing a doctor shortage for seniors on Medicare. That causes longer wait times, longer driving distances or both when it comes time to see a doctor.

To read more, click on the link below.

http://blogs.marketwatch.com/encore/2013/07/29/more-disgruntled-doctors-leave-medicare/tab/print/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

More People Are Signing Up For Medicare Advantage Plans


In the BenefitsPro article by Kathryn Mayer it mentions that Medicare Advantage enrollments are on the rise from the previous year. It states that aggregated enrollment in Medicare Advantage plans hit 15.1 million in December, up nearly 1.3 million members since December 2012, according to a new report by Mark Farrah Associates.

The growth comes despite some obstacles such as: pricing concerns, reductions in service areas, loss of some carriers, reduction in providers, etc. To read more click on the link below.


http://www.benefitspro.com/2014/01/07/medicare-advantage-enrollment-tops-15-million?ref=hp


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Must I Sign Up For Medicare When I Turn 65 If I Receive Health Care Through The Department Of Veteran Affairs?


According to an AARP article by Patricia Barry (author of AARP’s Medicare for Dummies) the answer is no, but the VA Strongly recommends that you do.

Several reasons why you should have both:

  • VA health benefits are not set in stone. So if funding levels ever change, your coverage could change as well or you could possibly even lose your health benefits altogether.
  • Having both Medicare and VA coverage could save you lots of money if you need urgent care a long distance from a VA facility.
  • If you don’t enroll in Medicare when you are first eligible and decide you want to enroll later on, you’ll need to pay permanent penalties for signing up late. (For Part B that comes to 10% penalty added to your premium for every year you delayed. For Part D that comes to 1% penalty added to your premium for every month you delayed, if you didn’t have credible coverage.)


Source:
AARP Bulletin Oct 2014 Page 35
http://pubs.aarp.org/aarpbulletin/201410_DC?pg=35#pg35


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

New Drug Pricing Plan - Will It Ever Happen?


I was reading two different articles on the possibility of a new drug pricing plan for the future.


Read the actual 2 articles by clicking the web links below:


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

New Enrollment Period Option For Medicare Advantage Plans Started in 2019 & Is Called Medicare Open Enrollment Period!


As of 1/1/2019 and later there is a new enrollment period (actually an old one that came back). It is called Medicare OEP (Open Enrollment Period) which will run from January 1st through March 31stIndividuals may make only one election during the Medicare Advantage OEP. The effective date for an Medicare Advantage OEP election is the first month following the receipt of the enrollment application.

If you are already enrolled in a Medicare Advantage plan, you’ll have a one time opportunity to:

  • Switch to a different Medicare Advantage plan (MA-PD or MA-only)
  • Dis-enroll from your current Medicare Advantage plan and return to Original Medicare (with or without a Part D plan) and also add a Medicare Supplement if you so desire.


This new Open Enrollment Period is not to be confused with the AEP (Annual Enrollment Period) which still runs from October 15th through December 7th. So it is very important to understand these are two distinct enrollment periods and different rules apply to each! Also that this new OEP does not replace AEP, it is in addition to it.


Currently the existing Medicare Annual Enrollment Period (AEP) that runs from October 15th through December 7th, when members may make changes to their plans. They can move from one Medicare Advantage plan to another Medicare Advantage plan, change from a Medicare Advantage plan to a Medicare Supplement plan or from a Medicare Supplement plan to a Medicare Advantage plan. Members can also change stand alone part D drug plans at this time. There is no limit to how many times they can switch as long as it done between October 15th through December 7th, but the last choice they make by December 7th is final. 

The old Medicare Advantage Disenrollment Period (January 1 – February 14 every year) was discontinued, due to the addition of this new Medicare Advantage Open Enrollment Period.


NOTE: The new Medicare Advantage Open Enrollment Period does not provide an opportunity for a person enrolled in Original Medicare to join a Medicare Advantage plan. It also does not allow for Part D changes for individuals enrolled in Original Medicare, including those enrolled in stand alone Part D plans.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Original Medicare - What You Should Consider When Searching For Outpatient Services


When using Original Medicare, some things to consider and understand before receiving outpatient services:

  • You will need to satisfy (fully pay) your Part B annual deductible first before Original Medicare benefits kick in for Part B services. The Part B deductible may increase from year to year, and your annual deductible will reset each year, starting fresh on January 1st.

  • There are three different types of providers:

    • A "participating provider” is a provider that accepts Medicare and always takes assignment. Taking assignment means that the provider accepts Medicare’s approved amount for health care services as full payment. So in order to pay the least amount for outpatient services, you should go to a participating provider whenever possible. This type of provider (a participating provider) is required to submit a bill (file a claim) to Medicare for the care you receive from them. If you go to a participating provider then you are responsible for paying 20% coinsurance for Medicare covered services.

    •  A "Non-participating" provider accepts Medicare, but does not agree to take assignment in every case (however they may take assignment on a case by case basis). This means that while non-participating providers have signed up to accept Medicare insurance, they do not accept Medicare’s approved amount for your healthcare services as full payment. Non-participating providers can charge up to 15% more than Medicare’s approved amount for the cost of the services you receive (known as the limiting charge). This means that you are responsible for a total of up to 35% (20% coinsurance +15% limiting charge) of Medicare’s approved amount for covered services at a non-participating provider.

    • An “Opt-out provider" does not accept Medicare at all and has signed an agreement to be excluded from the Medicare program. This means they can charge whatever they want for services but must follow certain rules to do so. Medicare will not pay for care you receive from an opt-out provider (except in emergencies). You will be responsible for the entire cost of your care!


Bottom Line: Before you get service, make sure to ask you provider if they are participating, non-participating, or opt-out so you don’t have some unpleasant surprises when it comes to paying your bill!


Ready For The Annual Medicare Plan Decision?


Each year during a certain period (currently Oct. 15 through Dec. 7), known as annual enrollment period, you are allowed to change your existing Medicare Advantage plan or Prescription Drug Plan to a new plan. (Note: There are special election periods that allow for changes during other parts of the year for those who qualify.)

It is worth looking into your options whether to change plans or stick with the one you have. It may be wise to change plans due to your existing plan having undesirable changes in the upcoming year, or any health issues that may have changed for you since last year, or if you just weren’t happy with your existing plan.  

One Medicare plan type doesn’t fit all. There are advantages and disadvantages to each type. I like to present different options and let the client choose what they feel is actually best for their individual situation. Some folks like plans with no monthly premium, but have copays, and may have deductibles as well. (Kind of pay as you go). Then there are other plan types that clients basically pay a monthly premium upfront, but generally don’t have to worry about copays and deductibles for their medical expenses. (Although if they want prescription drug coverage they will need to purchase an additional plan, and those prescription drug plans do have copays, and some have deductibles as well.)

It is a smart idea to sit down with an experienced licensed agent that can help you understand your options, but doesn’t try to steer you towards one plan over another.

I can be reached at 941-404-5334 if you’d like to set up an appointment to discuss whether you feel switching to a new Medicare Insurance plan would be right for you.

Note: By calling this phone number, I understand I will be directed to a licensed insurance sales agent.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Retiree Insurance & Medicare - Important Information To Understand


If I have retiree insurance, do I need Medicare Part A & Part B?

Once you become eligible for Medicare, retiree insurance (insurance you get from a past job) is secondary to Medicare, which means that it pays after Medicare pays. If you have retiree insurance from your (or your spouse’s) former employer, generally it is a good idea to enroll in both Medicare Parts A and B as soon as you are eligible. This applies if you are eligible for Medicare because you are 65 or older or due to a disability. There are some exceptions such as if you have End-Stage Renal disease, etc.

Note: If you do not take Medicare when you are eligible and then later decide to enroll, you may have to pay a Part B penalty for late enrollment in addition to the monthly premium. Additionally, you may also have gaps in your coverage because you will have to wait until the General Enrollment Period to enroll in Part B. The General Enrollment Period is January 1 through March 31 each year, with coverage beginning July 1.


If I have retiree insurance, do I need Medicare Part D?

If you have prescription drug coverage through your retiree plan, you may not have to switch a Part D PDP (prescription drug plan) right away, unless you want to. It is best to check and compare each plan’s formulary (The list of covered prescription drugs the plan includes) to see which one fits you the best, as well as the copays, deductibles, etc.  If you decide to keep your prescription coverage continuously through your retiree insurance plan and your prescription plan’s coverage is creditable (meaning it is as good as or better than Medicare’s coverage) then you won’t get penalized later on when you decide to switch to a Medicare Part D prescription drug plan. However, keep in mind that if you have any gaps in prescription coverage after you are eligible for Part D, or you don’t have creditable prescription coverage, you will be charged 1% penalty per month going forward for the months that you didn’t have coverage at all or didn’t have credible coverage. 

Before making any decisions that involve your retiree coverage changes, you should always speak to your benefits administrator.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews



Retirees Get A Break On Medicare Drug Costs


This Wall Street Journal article by Matthew Heimer states that the Centers for Medicare & Medicaid Services announced that premiums for the Medicare Part D prescription drug plan should remain relatively stable in 2014. The article also mentions that consumer advocates and Medicare officials say that comparison shopping by consumers is helping to restrain overall costs. Click the link below to read more.

http://blogs.marketwatch.com/encore/2013/08/01/retirees-get-a-break-on-medicare-drug-costs/tab/print/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Senior Reference Web Sites & Phone Numbers


I have compiled a list of what I feel may be useful contact info for seniors. I actually have a tab on my web site main menu for Senior Reference Sites, but sometimes it gets overlooked. So I thought I would list it here as well.


Click this web link below for helpful web site contact information for seniors:

Senior Reference Sites


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Seniors Facing Higher Medicare Drug Premiums & Copays



A Sarasota HeraldTribune (Associated Press) article explains that the 2016 Medicare Prescription Drug plans premiums are increasing. In many cases so are the deductibles, copays, and coinsurance amounts that seniors have to pay.

The article goes on to say that it can really pay to shop Part D plans. You could end up saving a significant amount of money, depending on the drugs you take and on your individual circumstances. However one plan doesn’t fit all. 

To determine which Part D plan is best for you, calculate not only the total amount for premiums, but also add in any deductible, as well as copays and coinsurances for all your particular prescriptions. Lastly, be sure to check to verify all your drugs are still in the formulary (list of covered drugs in your plan) as they can change from year to year. If your drugs are not in the formulary, they are generally not covered at all!


To read the entire Sarasota HeraldTribune (Associated Press) article, click on the web link below:

http://www.heraldtribune.com/article/20151123/ARTICLE/151129882


------------------------------------------------------

Related AARP Bulletin Article by Patrica Barry.  (November 2015):

Save Money on Medicare in 2016

http://www.aarp.org/health/medicare-insurance/info-2015/save-money-in-medicare.html


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews




Time to Review Medicare in September!


If you are enrolled in a Medicare Advantage Plan or a stand-alone Part D prescription drug plan, you should receive an plan "Annual Notice of Change" (ANOC) and/or Evidence of Coverage (EOC) from your plan each fall. 

The ANOC includes any changes in coverage, costs, or service area that will be effective January 1st of the next year.

You, as a plan member, should receive this notice by the end of September and they will explain any changes that your plan will be making in the upcoming year. These changes can include information about changes to your plan’s list of covered drugs (formulary), copays, coinsurance, deductibles, other health benefits, and/or premium costs. It is important for you to read your mail from your plan to see if there are any changes that affect you. Review any changes to decide whether the plan will continue to meet your needs in the next year.


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Source: Courtesy of Insurance Associates Group


Two-Thirds Of Hospitals Fail A Medicare Test


This Wall Street Journal article by Matthew Heimer explains that the federal agency that administers Medicare will be reducing its reimbursement payments to 2,225 U.S. hospitals this fiscal year as a penalty for making insufficient progress on reducing readmission rates for the patients they treat. Some health care reformers feel that readmission can be a meaningful measure of the quality and cost of hospital care. Click the link below to read the whole article.

http://blogs.marketwatch.com/encore/2013/08/08/two-thirds-of-hospitals-fail-a-medicare-test/tab/print/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Untitled

Video - Guide On How To Choose A Medicare Plan


I found this very short but informative video explaining how to choose a Medicare plan, and thought I’d share the web link.


Click on the web link below to watch!

https://www.youtube.com/watch?v=b5eaVu5hrL0



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews




Video - Guide To Comparing Medicare Supplemental vs. Medicare Advantage Plans



I found this very short but informative video comparing Medicare Supplement Plans vs. Medicare Advantage Plans, and thought I’d share the web link.


Click on the web link below to watch!

https://www.youtube.com/watch?v=4kw4wlrJrPo


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews


Video - Guide To Understanding Medicare - Parts A & B Original Medicare


I found this very short but informative video explaining Parts A & B of Original Medicare, and thought I’d share the web link.


Click on the web link below to watch!

https://www.youtube.com/watch?v=S4v7CGYdeCU 


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews




Video - Guide To Understanding Medicare Advantage Plans



I found this very short but informative video explaining the basics of Medicare Advantage Plans, so I thought I’d share the web link.


Click on the web link below to watch!

https://www.youtube.com/watch?v=4NR0SJSqubo


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews



Video - Guide To Understanding Medicare Part D and Prescription Drugs


I watched this very short but informative video explaining the basics of Medicare Part D and Prescription Drugs, so I thought I’d share the web link.


Click on the web link below to watch!

https://www.youtube.com/watch?v=8cfAbG9EFH4



Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Video - Guide To Understanding Medigap (Medicare Supplement) Plans


This video is very short, but informative. It explains the basics of Medigap plans (also known as Medicare Supplement plans), so I thought I’d share the web link.


Click web link below to watch video:

https://www.youtube.com/watch?v=QoFBShKG9fA


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews




Video - Retirement and Medicare Basics


I thought I’d share this web link to a very short informative video. It explains retirement and Medicare basics.


Click web link below to watch video:

https://www.youtube.com/watch?v=KJWfuwxNCk8


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Video - Top 10 Medicare Insurance Tips


Click the web link below to watch a very short, but informative video. It gives 10 Medicare tips, so I figured it would be nice to share it.

https://www.youtube.com/watch?v=xCjz6Gtfdf4


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews




Video - Why Are Prescription Drugs So Expensive In The United States?


I watched a very short but informative CNN Money Video and thought I’d share it. Also at the same web link is an article entitled, “The 5 most expensive drugs in the United States.”


Click on web link below to read article and/or view short video.

https://www.cnn.com/2018/05/11/health/most-expensive-prescription-drugs/index.html


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

When can I change my existing Medicare Plan?


If you are already enrolled in a Medicare Advantage or Prescription Drug plan, you may only change your existing Medicare Plan during a qualified period. The Annual Election Period is the main period most people change plans. However, the Open Enrollment Period is a time you can change out of a "Medicare Advantage" plan. (See below for more details.) The only other period to make Medicare plan changes are if you qualify for a SEP (Special Election Period). To find out more about Special Election Periods or to understand if you qualify for one, read below.

Annual Election Period - Oct. 15 to Dec. 7. 

  • Switch, Drop, or Enroll in a Medicare Advantage, Medicare Supplement, and/or Prescription Drug plan)


Open Enrollment Period - Jan 1 - March 31. 

If you are already enrolled in a Medicare Advantage plan, you’ll have a one time opportunity to:

  • Switch to a different Medicare Advantage plan (MA-PD or MA-only)
  • Disenroll from your current Medicare Advantage plan and return to Original Medicare (with or without a Part D plan) and/or add a Medicare Supplement if you so desire.


(Note: Open Enrollment Period is for Medicare Advantage Plans only). As I mentioned above you can leave your Medicare Advantage plan and switch to Original Medicare. (If you switch to Original Medicare, you can also sign up for a prescription drug plan up to March 31 as well). During this period you
cannot do the following: Switch from Original Medicare to a Medicare Advantage plan OR Switch from your current Stand Alone Drug plan to another Stand Alone Drug Plan.)


Special circumstances (SEP) Special Enrollment Periods1

You can make changes to your Medicare Advantage and Medicare prescription drug coverage when certain events happen in your life, like if you move or you lose other insurance coverage. These chances to make changes are called Special Enrollment Periods (SEPs). Rules about when you can make changes and the type of changes you can make are different for each SEP.1


You change where you live1

  • I moved to a new address that isn't in my plan's service area.
  • I moved to a new address that’s still in my plan's service area, but I have new plan options in my new location.
  • I moved back to the U.S. after living outside the country.
  • I just moved into, currently live in, or just moved out of an institution (like a skilled nursing facility or long-term care hospital).
  • I'm released from jail.


You lose your current coverage1

  • I'm no longer eligible for Medicaid.
  • I left coverage from my employer or union (including COBRA coverage).
  • I involuntarily lose other drug coverage that's as good as Medicare drug coverage (creditable coverage), or my other coverage changes and is no longer creditable.
  • I had drug coverage through a Medicare Cost Plan and I left the plan.
  • I dropped my coverage in a Program of All-inclusive Care for the Elderly (PACE) plan.


You have a chance to get other coverage1

  • I have a chance to enroll in other coverage offered by my employer or union.
  • I have or am enrolling in other drug coverage as good as Medicare prescription drug coverage (like TRICARE or VA coverage).
  • I enrolled in a Program of All-inclusive Care for the Elderly (PACE) plan.


Your plan changes its contract with Medicare1

  • Medicare takes an official action (called a "sanction") because of a problem with the plan that affects me.
  • Medicare ends (terminates) my plan's contract.
  • My Medicare Advantage Plan, Medicare Prescription Drug Plan, or Medicare Cost Plan's contract with Medicare isn't renewed.


Other special situations1

  • I'm eligible for both Medicare and Medicaid.
  • I qualify for Extra Help paying for Medicare prescription drug coverage.
  • I'm enrolled in a State Pharmaceutical Assistance Program (SPAP) or lose SPAP eligibility.
  • I dropped a Medigap policy the first time I joined a Medicare Advantage Plan.
  • I have a severe or disabling condition, and there’s a Medicare Chronic Care Special Needs Plan (SNP) available that serves people with my condition.
  • I'm enrolled in a Special Needs Plan (SNP) and no longer have a condition that qualifies as a special need that the plan serves.
  • I joined a plan, or chose not to join a plan, due to an error by a federal employee.
  • I wasn't properly told that my other private drug coverage wasn't as good as Medicare drug coverage (creditable coverage).
  • I wasn't properly told that I was losing private drug coverage that was as good as Medicare drug coverage (creditable coverage).




1. Source: Special circumstances (Special Enrollment Periods) 
https://www.medicare.gov/sign-up-change-plans/when-can-i-join-a-health-or-drug-plan/special-circumstances/join-plan-special-circumstances.html


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Why Medicare Advantage Costs Taxpayers Billions More Than It Should


In this interesting Center for Public Integrity article by Fred Schulte, David Donald, and Erin Durkin it mentions that Medicare Advantage plans on average received about $9,900 per person in 2011. If you divide that out it comes to about $825/month per person! (Payments are based on a risk score that is supposed access the overall health of each patient. That amount listed above is an average since Medicare pays higher rates for sicker patients that are likely to require more costly medical services and less for healthy people.)

Medicare Advantage, a program that was created by Congress in 2003, was originally designed to help stabilize health care spending on the elderly. However the plans have sharply driven up costs in many parts of the United States due to overcharges, suspect billings, and billing errors, etc.

To read the full article click on the link below.

http://www.publicintegrity.org/2014/06/04/14840/why-medicare-advantage-costs-taxpayers-billions-more-it-should


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews

Why Spouses Should ‘Split Up’ For Medicare


A Wall Street Journal article by Anne Tergesen, mentioned that spouses with different medical needs may be better served to have different Medicare Insurance plans. The article reminds folks that just because you were on the same health insurance plan during your work years, doesn't mean that you both need to be on the same Medicare healthcare plan. The article also goes on to say that some people make the mistake of assuming plans that charge the highest premiums deliver the most generous benefits and that is not necessarily the case. 

Unfortunately the original web link is no longer accessible, but I listed the source below anyway.

Source: http://blogs.marketwatch.com/encore/2013/10/08/why-spouses-should-split-up-for-medicare/


Note: Medicare Insurance information can be overwhelming and confusing to many people. As an independent licensed agent I can explain things to you in simple terms so you feel comfortable making a decision. Then I can help you choose and enroll in a plan that you feel fits your needs.

By the way, it doesn’t cost you any more if you enroll in a Medicare Insurance plan through me as an independent agent versus directly with an insurance company either over the phone or via the Internet, since I get paid by the insurance companies for your enrollment. Plus you will have personalized service by a local agent. If you would like my assistance, please call me at 941-404-5334.

By calling this number, I understand I will be directed to a licensed insurance sales agent.

Please take a few seconds to read what my actual clients have to say about my personalized service in their own words by clicking this link. Insurance Agents Reviews